病人健康问卷抑郁自评量表（PHQ-9）的临床应用

病人健康问卷（Patient Health Questionnaire-9,PHQ-9）是一个简便、有效的抑郁障碍自评量表,在抑郁症诊断的辅助和症状严重程度评估方面,均具有良好的信度和效度.在基于评估的治疗策略中,PHQ-9可以作为制订治疗方案的参考,以及治疗过程中对疗效的评估工具.PHQ-9的衍生版本PHQ-8,PHQ-2和他评量表PHQ-9-OV,针对不同研究对象,有着相应的临床应用效果.现就PHQ-9在临床的应用及优势进行论述.     

生物反馈治疗卒中后焦虑抑郁状态伴失眠的研究

目的 研究生物反馈治疗卒中恢复期焦虑抑郁状态伴失眠的疗效及安全性。 方法 纳入卒中恢复期焦虑抑郁伴失眠患者,均给予生物反馈训练,训练方法为每周五次,每次 30 min的自主神经系统放松康复训练。所有患者在训练前后评定汉密尔顿焦虑量表（Hamilton Anxiety Scale,HAMA）、汉密尔顿抑郁量表（Hamilton Depression Scale,HAMD）、匹兹堡睡眠质量指数量表 （Pittsburgh Sleep Quality Index,PSQI）、患者健康问卷-9（Patient Health Questionnaire-9,PHQ-9）、简 易精神状态检查表（Mi ni -mental State Examination,MMSE）、Fugle-Meyer肢体功能评分（Fugl e-Meyer Scale,FMS）、美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）以及 Barthel指数（Barthel Index,BI）,并采集患者的睡眠时间,对比分析训练前后这些量表评分及睡眠时 间的变化。 结果 研究共纳入并完成3 0例患者的数据统计。治疗后患者睡眠时间较治疗前显著增 加[（4.81±1.58）h vs（7.30±1.34）h,P＜0.001]。HA M A[（17.50±8.41）vs（9.00±7.01）]和 HAMD（[ 19.53±7.82）vs（9.23±4.42）]评分均有显著改善（均P＜0.001）。训练4周后患者的MMSE评 分有提高,Fugl e-Meyer分数增加,Barthel指数增加,但无统计学意义,NIHSS评分降低,差异有显著性 （P =0.033）。 结论 生物反馈疗法有利于卒中后焦虑抑郁伴失眠患者的睡眠和情绪改善,提高康复效果。     

护士使用简易老年焦虑问卷筛查老年广泛性焦虑障碍的信效度

目的评价护士使用中文版简易老年焦虑问卷（Geriatric Anxiety Inventory—Short Form,GAI--SF）用于筛查老年焦虑时的信度和效度。方法某综合医院门诊就诊的老年人97名为研究对象,由护士进行GAI—SF问卷及汉密尔顿焦虑量表（Hamilton Anxiety Scale,HAMA）评定,并且由两名精神科主治医师根据ICD-10广泛性焦虑障碍诊断标准进行诊断性面谈。计算组内相关系数考察评定者抑制性,计算克朗巴赫-α系数评价问卷内部一致性;计算两次测量得分相关系数考评问卷的重测信度,采用主成分分析方法考评问卷结构效度;通过GAI—SF与HAMA的相关分析来考评问卷的效标效度;以临床标准为参考标准,根据ROC曲线下面积（Area Under Curve,AUC）来判断GAI—SF的区分效度以及划定问卷的划界分。结果（1）信度：GAI—SF问卷总分评定者组内相关系数为0．73,表明评定者一致性较好,总克朗巴赫-α系数为0．87,表明问卷内部一致性好。间隔15d两次测量问卷评分相关系数为0．78,说明问巷具有较好的重测信度。（2）效度：主成分分析结果显示,问卷的每个条目都在主因子上有较高的负荷值（0．501～0．670）,说明问卷结构效度良好;GAI—SF与HAMA之间的相关系数为r=0．60,P〈0．05,说明问卷具有较好的校标效度。以临床评估标准为参考在区分焦虑问题时界值分为≥3时灵敏度为70．4％,特异度为75．0％,AUC为0．73。结论GAI—SF中文译本具有较好的信度和效度,能够区分老年广泛性焦虑问题;可使用该问卷筛查社区老年广泛性焦虑障碍。     

病人健康问卷抑郁量表(PHQ-9)在社区老年人群中的应用——信度与效度分析

目的检验病人健康问卷抑郁量表(PHQ-9)在老年人中的信度与效度。方法应用PHQ-9对社区622名老年人进行评定,进行同质性信度研究;1周后对随机抽取的61名老人进行再次评定,进行重测信度研究;从622名老人中抽取195名进行定式精神检查(SCID-Ⅰ)抑郁量表评定,进行PHQ-9的效度研究。结果PHQ-9内部一致性系数(Cronbach′α系数)为0.8325,条目间的相关系数为0.233～0.523,各条目与量表总分的相关系数为0.451-0.693。61名老人重测PHQ-9信度系数0.934,PHQ-9的灵敏度为88%,特异度为99%。结论PHQ-9在我国社区老年人群中也具有良好的信度与效度,并且条目简洁,操作方便,易于掌握和节省时间,值得在临床,尤其是基层社区卫生中心推广使用。     

线上问题管理加干预对焦虑人群情绪状态的疗效研究：一项随机对照研究

目的探讨线上问题管理加(problem management plus, PM+)干预对焦虑人群情绪状态的疗效。方法通过网络问卷的方式于2020年2月26日至3月15日调查新型冠状病毒疫情暴发期间普通人群的心理健康状态。共纳入90例广泛性焦虑障碍量表(Generalized Anxiety Disorder-7, GAD-7)≥5分的受试者入组, 采用随机数字表法分为等待治疗组(n=45)和线上PM+干预组(n=45)。线上PM+干预组接受为期3周, 每周2次的线上PM+干预, 等待治疗组接受一般的心理支持。采用GAD-7、患者健康问卷抑郁量表(Patient Health Questionnaire-9, PHQ-9)、躯体症状严重程度量表(Patient Health Questionnaire-15, PHQ-15)、知觉压力量表(Perceived Stress Scale-14, PSS-14)、失眠严重指数量表(Insomnia Severity Index, ISI), 于基线、3周干预结束后及6个月随访时对2组受试者进行心理评估。双因素重复测量方差分析比较2组基线与干预...     

缺血性卒中后焦虑抑郁与认知功能障碍的关系研究

目的 探讨缺血性卒中后焦虑抑郁与认知功能障碍的关系。 方法 选取2017年1月-2018年3月邯郸市第一医院收治的首发缺血性卒中患者98例,同期非缺血性 卒中入院的患者50例作为对照组。分别进行汉密尔顿焦虑量表（Hamilton anxiety scale,HAMA）、汉密 尔顿抑郁量表（Hamilton depression scale,HAMD）、日常生活能力量表(activity of daily living scale,ADL)、 蒙特利尔认知评估量表（Montreal cognitive assessment,MOCA）和NIHSS评测。比较两组的认知功能 障碍和焦虑、抑郁发生情况;对卒中组的ADL、MoCA、NIHSS评分与HAMA、HAMD评分进行相关性分析; 对ADL、MoCA、NIHSS评分进行相关性分析。 结果 卒中组中62例（63.3%）患者存在认知功能障碍,存在焦虑者53例（54.1%）,抑郁者42例 （42.9%）,对照组中存在认知功能障碍者14例（28%）,存在焦虑者17例（34.0%）,抑郁者9例（18.0%）。 卒中组MoCA和ADL评分均低于对照组,差异均有统计学意义。卒中组HAMA评分与ADL、MoCA和NIHSS 评分相关系数分别为r =-0.526（P＜0.001）、r =-0.592（P＜0.001）和r =0.412（P＜0.001）;HAMD评分 与ADL、MoCA和NIHSS评分的相关系数分别为r =-0.490（P＜0.001）、r =-0.571（P＜0.001）和r =0.606 （P＜0.001）;ADL与MoCA、NIHSS评分的相关系数分别为r =0.933（P＜0.001）和r =-0.842（P＜0.001）; MoCA与NIHSS评分的相关系数为r =-0.911（P＜0.001）。 结论 ①缺血性卒中后焦虑及抑郁的发生率较高且与认知功能障碍相关;②缺血性卒中后焦虑、 抑郁越重,其神经功能缺损的程度越重,日常生活能力越差。     

病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信效度检验

目的检验病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信度和效度。方法方便抽取河南省济源、新乡两地共3所中学,再以班级为单位采用整群抽样方法抽取初中一年级到高中三年级的14~18岁在校中学生471名进行PHQ-9测查,同时进行美国《精神障碍诊断与统计手册(第4版)》(DSM-IV)临床定式访谈(SCID)抑郁量表评定和贝克抑郁量表(BDI)评定。在样本中选取88人4周后完成PHQ-9重测。结果 PHQ-9总分的Cronbachα系数为0.85,条目间相关系数为0.289~0.560,各条目与PHQ-9总分相关系数为0.616~0.730,4周后重测信度为0.88。PHQ-9总分与BDI总分Pearson相关系数为0.77,主成分因子分析显示因子(躯体化-情感因子)突出。PHQ-9评估抑郁情绪的最佳划界分为10分,灵敏度为93.33%,特异度为96.83%;ROC曲线下面积(AUC)为0.984(95%CI 0.969~0.993)。结论 PHQ-9应用于青少年抑郁情绪评估中具有良好的信度与效度,10分为该量表的最佳诊断划界分。     

PHQ-9在综合医院住院患者中信效度研究

目的检验病人健康问卷抑郁量表(PHQ-9)在综合医院住院患者中应用的信度和效度,探索PHQ-9在综合医院住院患者中快速筛查抑郁的可行性。方法方便抽取四川大学华西医院569名住院患者,在规定指导语下完成PHQ-9评定,采用随机数字表法随机抽取38名患者在完成初次评定2周后进行PHQ-9重测;以简明国际神经精神访谈(MINI)作为"金标准",评估中文版PHQ-9的效标效度,共139名患者接受MINI中文版访谈。结果 PHQ-9在本研究中的Cronbach'sα系数为0.839,各条目与总评分的相关系数r=0.484~0.724(P0.01),各条目间相关系数r=0.229~0.520(P0.01);两周后重测系数r=0.846(P0.01);因子分析获得3个公因子,分别为自我评价因子、情感因子和躯体化因子;最佳诊断划界分为8分,敏感度为92.6%,特异度为60.6%;PHQ-9的ROC曲线下面积为0.841(95%CI:0.777~0.905)。结论 PHQ-9应用于综合医院住院患者抑郁评估中具有良好的信效度,8分为该量表的最佳划界分。     

新型冠状病毒肺炎疫情对卒中住院患者认知功能及心理状态的影响

目的 分析新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）疫情对卒中住院患者认知功能 和心理状态的影响。 方法 本研究回顾性纳入2020年1月1日-4月30日COVID-19疫情期间于首都医科大学附属北京天坛 医院神经内科住院的卒中患者作为观察组,以2019年1月1日-4月30日同科室住院的卒中患者为对照 组。比较两组患者住院期间MoCA和9项患者健康问卷（patient health questionnare-9,PHQ-9）抑郁症筛 查量表评分的差异;比较两组患者3个月随访时的抑郁症筛查量表-2项患者健康问卷（Patient Health Questionnare-2,PHQ-2）评分的差异。 结果 本研究共纳入观察组患者106例,对照组患者180例。观察组患者既往心房颤动病史比例较 高（13.21% vs 4.44%,P＝0.01）、既往心肌梗死病史比例较低（0 vs 5.56%,P＝0.01）。住院期间,两 组患者MoCA评分差异无统计学意义,观察组PHQ-9抑郁症筛查量表得分[13（11～16）vs 7（4～11）,P ＜0.01]显著高于对照组。以PHQ-9评分≥10分作为诊断抑郁情绪的界值,观察组出现卒中后抑郁情 绪的比例高于对照组（39.62% vs 35.00%,P＜0.01）。3个月随访时,观察组PHQ-2评分高于对照组[4 （3～5）vs 3（2～4）,P＜0.01]。 结论 COVID-19疫情时期卒中住院患者更易出现抑郁情绪,应给予相应的心理干预,以改善患者心 理健康状况。     

中文版精神疾病愤怒量表的信度和效度 评价

目的 检验中文版精神疾病愤怒量表（PARS）的信度和效度。方法 经原著者同意,汉 化英文版精神疾病愤怒量表,该量表包括41 个条目,利用该量表于2016 年1—12 月在上海市精神卫生 中心对125 例精神疾病患者进行评估,Cronbach''s α 计算内部一致性信度,Guttman Split-Half 计算分半 信度;计算每个条目与总分的Pearson 相关系数,并应用探索性因子分析检测PARS 的结构效度;应用 Pearson 相关分析探讨PARS 与阳性与阴性症状量表（PANSS）的校标关联效度。结果 中文版RARS 的 Cronbach''s α 系数为0.89,Guttman Split-Half 系数为0.88;各条目与总分之间的相关系数在0.19～0.72 （P＜ 0.05）;探索性因子分析共得出9 个因子,解释总方差的67%;PARS 与PANSS 中G14 条目（愤怒控制 缺乏）存在明显相关（r=0.54,P＜ 0.05）。结论 中文版PARS评估精神疾病愤怒症状具有良好的信度和 效度,可用于我国精神疾病患者愤怒的症状研究。     

Validation of the Patient Health Questionnaire-9 Korean version in the elderly population: the Ansan Geriatric study

OBJECTIVE: We evaluated the diagnostic validity of the 9-item depression module of the Patient Health Questionnaire-9 (PHQ-9) in elderly Korean patients and suggest an optimal cutoff score to screen for major depressive disorders. METHOD: The PHQ-9 and an elderly health questionnaire were administered to 1060 subjects older than 60 years, chosen using a stratified random sample of the community. The PHQ-9 was measured and compared with the Geriatric Depression Scale, Center for Epidemiological Studies Depression Scale, and Beck Depression Inventory scores. Reliability and validity tests, factor analysis, and receiver operating characteristic curve analysis were performed. RESULTS: The PHQ-9 indicated that 175 subjects had depressive disorders, and 885 subjects were rated as healthy. The PHQ-9 showed significant positive internal consistency (r = 0.88) and test-retest reliability (r = 0.60). The convergent validity with Geriatric Depression Scale and Center for Epidemiological Studies Depression Scale was significantly positive (r = 0.74 and 0.66, respectively). We suggest a score of 5 as the optimal cutoff point when screening for depressive disorders using the PHQ-9. CONCLUSIONS: The Korean version of the PHQ-9 is an appropriate diagnostic tool for depression, and a score of 5 is the optimal cutoff for Korean elderly subjects. Screening for depression in the elderly population using the PHQ-9 would be valuable when medically ill patients show depressive symptoms in a primary health care setting.     

The Reliability and Validity of Post Stroke Depression Scale in Different Type of Post Stroke Depression Patients

ObjectiveA self-rating post stroke depression scale (PSDS) showed a good reliability and validity to assess severity of depressive symptoms among stroke patients. This study aimed to retest the psychometric properties of PSDS in different types of post-stroke depression (PSD).Materials and methodsA total of 170 stroke patients were recruited in the study. 82 and 25 patients were respectively diagnosed as PSD symptoms disorder (PSDSD) and PSD disorder (PSDD) patients according to their respective diagnostic criteria. The PSDS and the 9-item Patient Health Questionnaire (PHQ-9) were used to assess the severity of depression. Cronbach α, Spearman rank coefficient and independent sample t-test were conducted to examine reliability, internal consistency and discriminate validity. Then the receiver operating characteristic curve and Youden index were used to performance evaluation and cut-off value respectively in different subtypes of PSD patients.ResultsThe Cronbach α of PSDS was 0.857, indicting a good reliability. The Spearman correlation coefficient between PSDS and PHQ-9 was 0.942 (P<0.001). The discriminate validity displayed significant difference between PSDSD as well as PSDD and no depression patients (all P<0.001). 5/24 and 10/24 were the cut-off value for PSDSD and PSDD patients.ConclusionsPSDS is a useful screen tool with an acceptable psychometric properties for estimation of different subtypes of PSD patients.     

The Patient Health Questionnaire-9 for measuring depressive symptoms among the general population in Hong Kong

ObjectivesThe Patient Health Questionnaire-9 (PHQ-9) assesses depressive symptoms by self-report, is brief, and was developed to correspond to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for major depression. This article presents information regarding its reliability and validity and the distribution of scores in a Chinese community sample in Hong Kong.MethodsA total of 6028 participants 15 years or older were recruited using random household sampling. They completed the Chinese version of the PHQ-9, the Happiness Scale, the Chinese Health Questionnaire, and the Short-Form 12-Item Health Survey (SF-12). Information was also gathered on health and health service use.ResultsExploratory factor analysis and confirmatory factor analysis supported a single factor with strong loadings for all 9 items. Multiple-group analyses demonstrated that the structure can be generalized across sex and age groups (ie, adolescents, adults, and individuals 65 years or older). The internal consistency of the PHQ-9 was 0.82. The test-retest reliability over a 2-week interval was 0.76. As expected, the total score of the PHQ-9 was significantly associated with the Chinese Health Questionnaire (r = 0.49) and the Happiness Scale (r = ?0.41). In addition, as expected, the relationship with the physical component subscale of the SF-12 was significantly weaker (r = ?0.27) than for the mental component subscale of the SF-12 (r = ?0.60). Participants with higher scores on the PHQ-9 were more likely to report having been diagnosed with depression by a physician, having chronic illness, using medicine, and using inpatient and outpatient health services. Almost 40% of participants did not report any depressive symptoms (score, 0). Self-reported symptoms at a level that would qualify for a diagnosis of major depressive disorder were provided by 1.7% of the participants.ConclusionsOur data support the reliability and validity of the PHQ-9 in assessing depressive symptoms among the general population in Hong Kong. Its validity against diagnostic interview for major depressive disorder and its sensitivity and specificity should be determined in future studies.     

The patient health questionnaire-15 and its abbreviated version as screening tools for depression in Korean college and graduate students

Objective

Over half of all suicides worldwide occur in Asia. Given the close association between suicide and depression, it is quite unexpected that depression is least frequently diagnosed in Asia. This is, in part, due to the fact that Asians somatize depression. Young adults including college and graduate students are no exceptions. Therefore, a somatic symptom-focused screening tool would be useful in detecting depression in Asian college and graduate students. The purpose of this study was to evaluate the psychometric properties of the Patient Health Questionnaire-15 (PHQ-15) in screening for depression among Korean college and graduate students. In addition, we developed an abbreviated version of the PHQ-15 (aPHQ-15) and studied validity measures.

Methods

Three-hundred and fifty Korean college and graduate students were screened with the PHQ-15. Of all participants, 176 were interviewed using the Structured Clinical Interview for DSM-IV to diagnose major depressive episode, while the other 174 were evaluated with the Beck Depression Inventory-II (BDI-II) and the Inventory of Depressive Symptomatology-Self-Report (IDS-SR). Reliability and validity measures including the internal consistency, test–retest reliability, and criterion, convergent, and divergent validity were tested. Principal component analysis was used in developing the abbreviated version of the PHQ-15.

Results

The PHQ-15 showed good internal consistency and test–retest reliability (Cronbach's alpha 0.82, intra-class correlation coefficient 0.87). The optimal cut-off point for detecting depression was estimated to be 8. There were strong correlations between the PHQ-15 total scores and self-report measures of depressive symptom severity (BDI-II: r = 0.69 and p < 0.001, IDS-SR: r = 0.77 and p < 0.001). The 5-item aPHQ-15 had comparable validity with the PHQ-15.

Conclusions

The somatic symptom-focused PHQ-15 and aPHQ-15 can work as effective screening tools for depression.     

Validity of the patient health questionnaire-9 for depression screening and diagnosis in East Africa

Depression is often underdiagnosed and undertreated in primary care settings, particularly in developing countries. This is, in part, due to challenges resulting from lack of skilled mental health workers, stigma associated with mental illness, and lack of cross-culturally validated screening instruments. We conducted this study to evaluate the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) as a screen for diagnosing major depressive disorder among adults in Ethiopia, the second most populous country in sub-Saharan Africa. A total of 926 adults attending outpatient departments in a major referral hospital in Ethiopia participated in this study. We assessed criterion validity and performance characteristics against an independent, blinded, and psychiatrist administered semi-structured Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. Overall, the PHQ-9 items showed good internal (Cronbach's alpha=0.81) and test re-test reliability (intraclass correlation coefficient=0.92). A factor analysis confirmed a one-factor structure. Receiver Operating Characteristics (ROC) analysis showed that a PHQ-9 threshold score of 10 offered optimal discriminatory power with respect to diagnosis of major depressive disorder via the clinical interview (sensitivity=86% and specificity=67%). The PHQ-9 appears to be a reliable and valid instrument that may be used to diagnose major depressive disorders among Ethiopian adults.     

Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan

Purpose

The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire (PHQ-9) for the purpose of screening major depressive disorder (MDD) among primary care patients in Taiwan.

Method

A total of 1954 primary care patients completed the PHQ-9. Patients (n = 1532) were interviewed using the Schedule for Clinical Assessments in Neuropsychiatry and 17-item of Hamilton Rating Scale. Subsample cases were retested within 2 weeks.

Results

The PHQ-9 had a good internal consistency (α = .80) and test-retest reliability (intraclass correlation coefficient = 0.87). A principal component factor analysis yielded 1-factor structure, which accounted for a total of 42.0% of the variance. The PHQ-9 was significantly correlated with the external validators such as the 17-item of Hamilton Rating Scale and the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (P < .001). Using the Schedule for Clinical Assessments in Neuropsychiatry interview as the criterion standard, a PHQ-9 score of 10 or higher had a sensitivity of 0.86 and a specificity of 0.94 for recognizing MDD. The screening accuracy of the 2 items version, PHQ-2, was also satisfactory (scores ≥2: sensitivity 0.88; specificity 0.82). The single-question screen, PHQ-1 (depressed mood), was 78% sensitive and 93% specific for detecting MDD (score ≥2).

Conclusion

The PHQ-9 and its 2 subscales, PHQ-2 and PHQ-1, seem reliable and valid for detecting MDD among Chinese primary care patients.     

Depression and Somatic Symptoms May Influence on Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Preliminary Study

The present study is the first one to investigate the impacts of depression and somatization on the disease severity and quality of life (QoL) in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The Korean version of National Institutes of Health (NIH)- Chronic Prostatitis Symptom Index (CPSI) for severity of CP/CPPS. Korean version of Patient Health Questionnaire-9 (PHQ-9) for depression, Korean version of Patient Health Questionnaire-15 (PHQ-15) for somatization, and Korean version of EuroQol Questionnaire-5 Dimensions (EQ-5D)- [(EQ-5D utility index and visual analog scale (EQ-5D VAS)] for QoL, were administered. Eighty patients were enrolled. The NIH-CPSI total scores were significantly higher in those with depression (25.3%, p=0.01) or somatization (23.2%, p=0.03) than in those without. These trends toward significantly negative influence of depression and somatic symptoms on QoL were also observed. Our preliminary results indicate that depression and somatization may have negative influence on the symptom severity and QoL in patients with CP/CPPS. However, adequately-powered and more well-designed studies are mandatory to prove our results.     

躯体形式障碍与躯体症状障碍患者临床特征比较

目的探索三甲综合医院门诊躯体形式障碍(somatoform disorder,SFD)和躯体症状障碍(somatic symptom disorder,SSD)患者临床特征的差异。方法采用方便取样法纳入消化内科、神经内科、中医科、精神科门诊候诊患者,完成患者健康问卷躯体症状群量表(Patient Health Questionnaire-15,PHQ-15),患者健康问卷抑郁量表(Patient Health Questionnare-9,PHQ-9),广泛性焦虑障碍量表(General Anxiey Disorder Scale,GAD-7),躯体症状障碍诊断B标准量表(Somatic Symptom Disorder-B Criteria Scale,SSD-12),世界卫生组织残疾评定方案2.0(WHO Disability Assessment Schedule 2.0,WHO DAS 2.0)等自评问卷,并经结构化访谈得出SSD和SFD诊断,采用独立样本t检验分析并比较SSD和SFD患者的临床特征及差异。结果699例受访者中,236例(33.8%)和431例(61.7%)分别被诊断为SSD和SFD,二者诊断一致性较低(Cohenκ=0.291 P<0.01)。SSD患者在PHQ-15[(12.01±5.54)分比(10.38±5.53)分,t=3.624]、PHQ-9[(11.84±6.76)分比(9.40±6.57)分,t=4.546]、GAD-7[(9.70±6.08)分比(7.34±5.92)分,t=4.871]、SSD-12[(23.60±11.43)分比(16.52±12.64)分,t=7.154]和WHO DAS 2.0[(22.65±8.52)分比(19.96±7.77)分,t=4.128]量表得分显著高于SFD患者,均P<0.01。结论SSD和SFD诊断一致性较低;相对于SFD患者,SSD患者在躯体症状负荷、焦虑抑郁情绪、与症状相关情绪、思维和行为问题、社会功能损害更严重。     

Assessment of mood: Guides for clinicians

Objective

This article is one of the series of review articles aiming to present a convenient guideline for practicing clinicians in their selection of scales for clinical and research purposes. This article focuses on assessment scales for mood (depression, mania).

Methods

After reviewing the basic principles of clinical psychometrics, we present a selective review of representative scales measuring depressed or manic mood.

Results

We reviewed and reported on reliability, validity, interpretability, and feasibility of the following rating scales: Patient Health Questionnaire-9 (PHQ-9), K6, Beck Depression Inventory II (BDI-II), and Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) as self-report scales for depressed mood; Hamilton Rating Scale for Depression (HAM-D) and Montgomery–Asberg Depression Rating Scale (MADRS) as clinician-administered measure for depression; and Young Mania Rating Scale (YMRS) as a clinician-administered instrument for mania.

Conclusion

Although the rating scales for mood represent a well-trodden terrain, this brief review of the most frequently used scales in the literature revealed there is still some room for improvement and for further research, especially with regard to their clinical interpretability.