The Patient Health Questionnaire-2 - Validity of a two-item depression screener
The Patient Health Questionnaire-2 - Validity of a two-item depression screener
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DOI：
10.1097/01.mlr.0000093487.78664.3c
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发表时间：
2003-11-01
期刊：
影响因子：
3
通讯作者：
Williams, JBW
中科院分区：
文献类型：
--
作者：
Kroenke, K;Spitzer, RL;Williams, JBW
背景许多自我管理的问卷可用于评估抑郁症的严重程度，包括9项患者健康问卷抑郁模块（PHQ-9）。因为在忙碌的临床环境中或作为综合健康问卷的一部分，甚至更简短的测量可能是可取的，我们评估了PHQ抑郁模块的2项版本，PHQ-2。PHQ-2询问了过去2周内抑郁情绪和快感缺乏的频率，得分为0（“完全没有”）至3（“几乎每天”）。PHQ-2由8个初级保健诊所和7个妇产科诊所的6000名患者完成。使用20项简式一般健康调查，自我报告的病假和诊所就诊，以及与疾病相关的困难来评估结构效度。标准效度进行了评估，对一个独立的结构化的心理健康专业人士（MHP）在580例患者的样本采访。随着PHQ-2抑郁严重程度从0增加到6，所有6个SF-20分量表的功能状态均显著降低。此外，与医疗有关的困难、病假和医疗保健利用率也有所增加。以MHP再访为标准，PHQ-2评分：3分诊断重性抑郁症的敏感性为83%，特异性为92%。似然比和受试者操作者特征分析确定PHQ-2评分3分为筛选目的的最佳临界点。结果在初级保健和妇产科样本中相似。PHQ-2的结构和效标效度使其成为一种有吸引力的抑郁症筛查工具。
BACKGROUND. A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2.METHODS. The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.RESULTS. As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score :3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples.CONCLUSION. The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.