Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda
Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda
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DOI：
10.1080/09540121.2013.764385
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发表时间：
2013-10-01
影响因子：
1.7
通讯作者：
Stein, Dan J.
中科院分区：
文献类型：
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作者：
Akena, Dickens;Joska, John;Stein, Dan J.
抑郁症在非洲非常普遍，艾滋病毒/艾滋病等疾病在那里很常见。本研究的目的是评估常用抑郁症筛查工具在识字率低的环境中的有效性，在这些环境中，患者可能无法自我管理抑郁量表。我们使用迷你国际神经精神病学仪器 (MINI) 作为金标准，对乌干达 368 名艾滋病毒/艾滋病患者 (PLWHA) 进行了研究，探讨了患者健康问卷 9 (PHQ-9)、抑郁症流行病学调查中心 (CES-D) 和 Kessler-10 (K-10) 的有效性。提取 K-10 和 PHQ-9 的较短版本来评估其与较长版本相比的性能。我们使用 STATA 11.2 来分析数据。该患者样本中 MINI 定义的抑郁症患病率为 17.4%。这三种仪器均表现良好，曲线下面积 (AUC) 范围为 0.82 至 0.96。 PHQ-9 显示出最佳性能特征，AUC 为 0.96，敏感性为 91.6%，特异性为 81.2%。提取的版本表现得比较温和。所有这三种仪器都显示出作为筛选工具的良好特性； PHQ-9 具有特别高的敏感性和特异性，因此可被认为可用于筛查 HIV 阳性患者的抑郁症。
Depressive disorders are highly prevalent in Africa where diseases such as HIV/AIDS are common. The aim of this study was to assess the validity of commonly used depression screening instruments in a setting characterized by low literacy, where patients may not be able to self-administer depression scales. We explored the validity of the Patient Health Questionaire-9 (PHQ-9), Centre for Epidemiological Surveys for Depression (CES-D), and the Kessler-10 (K-10), using the Mini International Neuropsychiatric Instrument (MINI) as a gold standard in 368 persons living with HIV/AIDS (PLWHA) in Uganda. The shorter versions of the K-10 and PHQ-9 were extracted to assess their performance in comparison to the longer versions. We used STATA 11.2 to analyze the data. The prevalence of a MINI defined depression in this patient sample was 17.4%. The three instruments all performed well, with areas under the curve (AUC) ranging from 0.82 to 0.96. The PHQ-9 showed the best performance characteristics with an AUC of 0.96, a sensitivity of 91.6%, and specificity 81.2%. The extracted versions performed more modestly. All three instruments showed good properties as screening tools; the PHQ-9 has particularly high sensitivity and specificity, and so can be considered useful for screening HIV-positive patients for depression.