Criterion-related validity and reliability of the Urdu version of the patient health questionnaire in a sample of community-based pregnant women in Pakistan.
Criterion-related validity and reliability of the Urdu version of the patient health questionnaire in a sample of community-based pregnant women in Pakistan.
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作者：
Gallis JA;Maselko J;O'Donnell K;Song K;Saqib K;Turner EL;Sikander S
抑郁症是低收入和中等收入国家（LMIC）中最普遍，但未被识别但可治疗的精神疾病之一。在这些地区，需要易于管理，有效和可靠的筛查工具来帮助检测抑郁症的症状。患者健康问卷（PHQ-9）是最广泛使用的抑郁症筛查工具之一。然而，由于缺乏研究来审查其在这种环境中的有效性和可靠性，其对巴基斯坦社区环境的适用性受到限制。目前的研究旨在证明标准相关的有效性和内部可靠性的乌尔都语版本的PHQ-9在巴基斯坦社区为基础的孕妇的样本相比，诊断性临床访谈，结构化临床访谈DSM疾病（SCID），使用数据从抑郁症治疗集群随机试验在巴基斯坦农村。研究人员于2014年10月至2016年2月期间接触了巴基斯坦农村低收入地区的孕妇，并在提供知情同意书后，使用乌尔都语版本的PHQ-9进行抑郁症筛查，其中≥10的临界值用于表示显著的抑郁症状。在PHQ-9之后，施用SCID的当前重性抑郁发作的诊断模块。我们研究了PHQ-9的心理测量学特性相比，SCID作为金标准，使用敏感性，特异性，阴性和阳性预测值来衡量标准相关的有效性的PHQ-9作为抑郁症症状的指标。我们计算受试者工作特征曲线下面积以确定诊断准确性，并使用Cronbach α评估内部可靠性。共有1，731名妊娠晚期的女性接受了重度抑郁症的评估。在这些女性中，572名（33%）符合PHQ-9上显著抑郁症状的截止值，454名（26%）使用SCID评估为抑郁症阳性。在临界值≥10时，PHQ-9的敏感性和特异性分别为94.7%和88.9%。阳性和阴性预测值分别为75.2%和97.9%，曲线下面积为0.959。内部可靠性，Cronbach的α测量，为0.844。有效和可靠的筛查工具，以协助检测抑郁症的症状，需要在低收入环境中抑郁症是非常普遍的。乌尔都语版本的PHQ-9以前没有在巴基斯坦孕妇的社区环境中对抑郁症进行过众所周知的评估。这项研究表明，乌尔都语版的PHQ-9在巴基斯坦社区孕妇中筛查抑郁症状具有可接受的标准相关效度和可靠性;当使用推荐的≥10分的截止评分时，它也可以作为重度抑郁症的准确筛查工具。
Depression is one of the most prevalent, yet unrecognized but treatable mental disorders in low and middle income countries (LMICs). In such locations, screening tools that are easy-to-administer, valid, and reliable are needed to assist in detecting symptoms of depression. The Patient Health Questionnaire (PHQ-9) is one of the most widely used depression screeners. However, its applicability to community-based settings of Pakistan is limited by the lack of studies examining its validity and reliability in such settings. The current study aimed to demonstrate the criterion-related validity and internal reliability of the Urdu version of the PHQ-9 in a sample of community-based pregnant women in Pakistan compared to a diagnostic clinical interview, the Structured Clinical Interview for DSM disorders (SCID), using data from a depression treatment cluster randomized trial in rural Pakistan. Pregnant women in a rural, low income sub-district in Pakistan were approached between October 2014 and February 2016 and, after providing informed consent, screened for depression using the Urdu version of the PHQ-9, with a cutoff of ≥10 used to indicate significant depressive symptoms. Following the PHQ-9, the diagnostic module for current major depressive episode of the SCID was administered. We examined the psychometric properties of PHQ-9 compared to SCID as a gold standard, using sensitivity, specificity, and negative and positive predictive value to measure the criterion-related validity of the PHQ-9 as an indicator of symptoms of depression. We computed area under the receiver operating characteristic curve to determine diagnostic accuracy, and used Cronbach’s alpha to assess internal reliability. A total of 1,731 women in their third trimester of pregnancy were assessed for major depressive disorder. Of these women, 572 (33%) met the cutoff for significant depressive symptoms on PHQ-9, and 454 (26%) were assessed positive for depression using the SCID. The sensitivity and specificity of PHQ-9 at a cutoff of ≥10 was 94.7% and 88.9%, respectively. The positive and negative predictive values were 75.2% and 97.9%, respectively; and the area under the curve was 0.959. Internal reliability, as measured by Cronbach’s alpha, was 0.844. Valid and reliable screening tools to assist in detecting symptoms of depressive disorder are needed in low income settings where depressive disorders are highly prevalent. The Urdu version of the PHQ-9 has not been previously validated against a well-known assessment of depression in a community setting among pregnant women in Pakistan. This study demonstrates that the Urdu version of the PHQ-9 has acceptable criterion-related validity and reliability for screening for depressive symptoms in Pakistan among community-based pregnant women; and when the recommended cut-off score of ≥10 is used it can also serve as an accurate screening tool for major depressive disorder.
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影响因子：
64.3
作者：
Maselko, Joanna;Sikander, Siham;Rahman, Atif
通讯作者：
Rahman, Atif
影响因子：
2.5
作者：
Sikander, Siham;Lazarus, Anisha;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
7
作者：
Manea, Laura;Gilbody, Simon;McMillan, Dean
通讯作者：
McMillan, Dean
影响因子：
4.4
作者：
Ahmer, Syed;Faruqui, Rafey A.;Aijaz, Anita
通讯作者：
Aijaz, Anita
DOI：
10.1016/s0140-6736(16)31460-x
发表时间：
2016-10-08
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2015 DALYs and HALE Collaborators
通讯作者：
GBD 2015 DALYs and HALE Collaborators