The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review
The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review
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DOI：
10.1016/j.genhosppsych.2010.03.006
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发表时间：
2010-07-01
影响因子：
7
通讯作者：
Loewe, Bernd
中科院分区：
文献类型：
--
作者：
Kroenke, Kurt;Spitzer, Robert L.;Loewe, Bernd
背景资料：抑郁、焦虑和躯体化是初级保健和医学专业人群中最常见的精神障碍;每种都存在于至少5-10%的患者中，并且经常彼此共病。测量和监测所有三个conditions.Methods的有效手段：证据的心理测量和务实的特点，病人健康问卷（PHQ）-9抑郁症，广泛性焦虑症（GAD）-7焦虑和PHQ-15躯体症状量表合成从两个来源：（1）4项多中心横断面研究（三项在初级保健中进行，一项在妇产科实践中进行），包括9740名患者，结果：PHQ-9及其简化版8项（PHQ-8）和2项（PHQ-2）对抑郁障碍的诊断具有良好的敏感性和特异性。同样，GAD-7及其简化的两项（GAD-2）版本在检测广泛性焦虑、恐慌、社交焦虑和创伤后应激障碍方面具有良好的操作特性。最佳分界点在母量表（PHQ-9和GAD-7）上为>= 10，在超简短版本（PHQ-2和GAD-2）上为>= 3。PHQ-15在评估躯体症状和筛查躯体形式障碍方面等同于或上级于其他简短的措施。5、10和15的临界点代表所有三个量表上的轻度、中度和重度症状水平。PHQ-9和GAD-7、PHQ-15对变化的敏感性已得到证实，但尚未确定。结论：PHQ-9、GAD-7和PHQ-15是一种简便有效的抑郁、焦虑和躯体化的检测和监测工具。(C)2010年由Elsevier Inc.出版
Background: Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable.Methods: Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales.Results: The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is >= 10 on the parent scales (PHQ-9 and GAD-7) and >= 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15.Conclusions: The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. (C) 2010 Published by Elsevier Inc.