Diagnostic Accuracy, Internal Consistency, and Convergent Validity of the Greek Version of the Patient Health Questionnaire 9 in Diagnosing Depression in Rheumatologic Disorders
Diagnostic Accuracy, Internal Consistency, and Convergent Validity of the Greek Version of the Patient Health Questionnaire 9 in Diagnosing Depression in Rheumatologic Disorders
复制标题
DOI：
10.1002/acr.20505
复制
发表时间：
2011-09-01
影响因子：
4.7
通讯作者：
Drosos, Alexandros A.
中科院分区：
文献类型：
--
作者：
Hyphantis, Thomas;Kotsis, Konstantinos;Drosos, Alexandros A.
Objective.患者健康问卷9（PHQ-9）是为了在社区、初级保健和医疗环境中筛查抑郁症而开发的。我们的目的是评估其诊断的准确性，内部一致性，可靠性，并在希腊患者的风湿性疾病的重性抑郁症（MDD）的诊断收敛效度。在一项2期抽样设计研究中，我们招募了475例确诊为风湿性疾病的患者。使用简易国际神经精神访谈法对2名高分者中的1名（PHQ-9评分≥ 9，n = 85）和3名低分者中的1名（PHQ-9评分0-8，n = 128）进行访谈，以确认MDD。进行受试者工作特征曲线分析以确定最佳阈值。量表的维度结构采用因子分析进行检验，内部一致性信度采用Cronbach’s alpha进行评估。心理困扰（症状自评量表-90-修订版[SCL-90-R]）、残疾（健康评估问卷残疾指数）和健康相关生活质量（HRQOL;世界卫生组织生活质量量表[WHOQOL-BREF]）也进行了评估，以检验双变量相关的收敛效度。在最佳阈值为10时，PHQ-9的敏感性为81.2%，特异性为86.8%。曲线下面积为0.91。PHQ-9呈现一维结构，具有良好的量表信度（α = 0.82）。PHQ-9评分与SCL-90-R抑郁量表（r = 0.736）和WHOQOL-BREF精神HRQOL量表（r = -0.571）的相关性最高，其他与残疾和HRQOL的相关性均在预期范围内。在截止值为10时，PHQ-9是希腊风湿病患者中筛查MDD的准确、可靠和有效的指标。
Objective. The Patient Health Questionnaire 9 (PHQ-9) was developed to screen for depressive disorders in community, primary care, and medical settings. We aimed to estimate its diagnostic accuracy, internal consistency, reliability, and convergent validity in diagnosing major depressive disorder (MDD) in Greek patients with rheumatologic disorders.Methods. In a 2-phase sampling design study, we recruited 475 patients with established rheumatologic disorders. One of 2 of the high scorers (PHQ-9 score >= 9, n = 85) and 1 of 3 of the low scorers (PHQ-9 score 0-8, n = 128) were interviewed using the Mini International Neuropsychiatric Interview to confirm MDD. A receiver operator characteristic curve analysis was performed to confirm the optimum threshold value. The scale's dimensional structure was tested with factor analysis, and internal consistency reliability was assessed with Cronbach's alpha. Psychological distress (Symptom Check List-90-Revised [SCL-90-R]), disability (Health Assessment Questionnaire disability index), and health-related quality of life (HRQOL; World Health Organization Quality of Life Instrument [WHOQOL-BREF]) were also assessed to test convergent validity with bivariate correlations.Results. At an optimum threshold of 10, the PHQ-9 showed a sensitivity of 81.2% and a specificity of 86.8%. The area under the curve was 0.91. The PHQ-9 presented unidimensional structure with good scale reliability (alpha = 0.82). The PHQ-9 score presented the greatest correlations with SCL-90-R depression (r = 0.736) and WHOQOL-BREF mental HRQOL scales (r = -0.571), and all other correlations with disability and HRQOL were in the expected direction.Conclusion. At a cutoff of 10, the PHQ-9 is an accurate, reliable, and valid measure for screening for MDD among Greek rheumatologic patients.