Validity and Utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for Screening and Diagnosis of Depression in Rural Chiapas, Mexico: A Cross-Sectional Study.
Validity and Utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for Screening and Diagnosis of Depression in Rural Chiapas, Mexico: A Cross-Sectional Study.
复制标题
患者健康问卷（PHQ）-2和PHQ-9的有效性和实用性用于筛查和诊断墨西哥农村奇亚帕斯的抑郁症：一项横断面研究。
DOI：
10.1002/jclp.22390
复制
发表时间：
2017-09
影响因子：
3
通讯作者：
Franke MF
中科院分区：
文献类型：
--
作者：
Arrieta J;Aguerrebere M;Raviola G;Flores H;Elliott P;Espinosa A;Reyes A;Ortiz-Panozo E;Rodriguez-Gutierrez EG;Mukherjee J;Palazuelos D;Franke MF
在资源有限的环境中，由于缺乏获得精神卫生保健的机会或卫生保健提供者无法识别它们，抑郁症经常被诊断出来。患者健康问卷（PHQ）‐2和PHQ‐9已被广泛用于初级保健机构的抑郁症筛查和诊断；然而，它们在农村、西班牙语人口中使用的有效性尚不清楚。我们采用横断面设计来评估PHQ‐9在抑郁症诊断中的心理测量特性，并估计PHQ‐2在抑郁症筛查中的敏感性和特异性。使用PHQ‐2、PHQ‐9和世界卫生组织生活质量BREF量表（WHOQOL‐BREF）从墨西哥恰帕斯州农村社区的223名成年人中收集数据。验证性因子分析表明，1因子结构拟合较好。PHQ‐9的内部一致性总体上是良好的（Cronbach’s alpha > = 0.8），对于由性别、文化程度和年龄定义的亚组来说也是如此。PHQ‐9显示出良好的预测效度：PHQ‐9诊断为抑郁症的参与者在总体WHOQOL‐BREF量表及其各领域的生活质量得分较低。以PHQ‐9结果为金标准，筛选抑郁症的最佳PHQ‐2临界值为3分（灵敏度80.00%，特异性86.88%，受试者工作特征曲线下面积= 0.89；95%可信区间[0.84,0.94]）。PHQ‐2和PHQ‐9显示出良好的心理测量特性，表明它们作为农村西班牙语人群抑郁症筛查和诊断工具的潜在益处。
Depressive disorders are frequently under diagnosed in resource‐limited settings because of lack of access to mental health care or the inability of healthcare providers to recognize them. The Patient Health Questionnaire (PHQ)‐2 and the PHQ‐9 have been widely used for screening and diagnosis of depression in primary care settings; however, the validity of their use in rural, Spanish‐speaking populations is unknown. We used a cross‐sectional design to assess the psychometric properties of the PHQ‐9 for depression diagnosis and estimated the sensitivity and specificity of the PHQ‐2 for depression screening. Data were collected from 223 adults in a rural community of Chiapas, Mexico, using the PHQ‐2, the PHQ‐9, and the World Health Organization Quality of Life BREF Scale (WHOQOL‐ BREF). Confirmatory factor analysis suggested that the 1‐factor structure fit reasonably well. The internal consistency of the PHQ‐9 was good (Cronbach's alpha > = 0.8) overall and for subgroups defined by gender, literacy, and age. The PHQ‐9 demonstrated good predictive validity: Participants with a PHQ‐9 diagnosis of depression had lower quality of life scores on the overall WHOQOL‐BREF Scale and each of its domains. Using the PHQ‐9 results as a gold standard, the optimal PHQ‐2 cutoff score for screening of depression was 3 (sensitivity 80.00%, specificity 86.88%, area under receiver operating characteristic curve = 0.89; 95% confidence interval [0.84, 0.94]). The PHQ‐2 and PHQ‐9 demonstrated good psychometric properties, suggesting their potential benefit as tools for depression screening and diagnosis in rural, Spanish‐speaking populations.