Validity and diagnostic accuracy of the Luganda version of the 9-item and 2-item Patient Health Questionnaire for detecting major depressive disorder in rural Uganda.
Validity and diagnostic accuracy of the Luganda version of the 9-item and 2-item Patient Health Questionnaire for detecting major depressive disorder in rural Uganda.
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DOI：
10.1017/gmh.2016.14
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Kigozi F
中科院分区：
文献类型：
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作者：
Nakku JEM;Rathod SD;Kizza D;Breuer E;Mutyaba K;Baron EC;Ssebunnya J;Kigozi F
乌干达农村社区的抑郁症患病率很高，但在初级保健环境中对抑郁症的检测和治疗并不理想。短期有效的抑郁症筛查措施可能会提高抑郁症的检测。我们描述了验证的卢甘达翻译的九项和两项患者健康量表（PHQ-9和PHQ-2）作为筛选工具，在乌干达东部的两个农村初级保健设施抑郁症。共有1407名成年受访者连续使用9项卢甘达PHQ筛选。其中212人被随机选择回答迷你国际神经精神访谈诊断问卷。对受访者的人口统计学特征和PHQ评分进行了描述性统计。测定PHQ-9和PHQ-2的灵敏度、特异性和阳性预测值（PPV）以及ROC曲线下面积。灵敏度和PPV之间的最佳权衡是在1005的临界值。PHQ-9和PHQ-2的受试者工作特征曲线下加权面积分别为0.74（95% CI 0.60-0.89）和0.68（95% CI 0.54-0.82）。PHQ-9的卢甘达翻译被发现在检测抑郁症方面有一定的用处。在乌干达农村初级保健环境中，PHQ-9的表现仅略好于PHQ-2。未来的研究可以通过考虑卢干达语使用者中的痛苦习语，并相应地修改PHQ-9来提高诊断的准确性。应谨慎看待PHQ-2在农村人口中的有用性。
The prevalence of depression in rural Ugandan communities is high and yet detection and treatment of depression in the primary care setting is suboptimal. Short valid depression screening measures may improve detection of depression. We describe the validation of the Luganda translated nine- and two-item Patient Health Questionnaires (PHQ-9 and PHQ-2) as screening tools for depression in two rural primary care facilities in Eastern Uganda. A total of 1407 adult respondents were screened consecutively using the nine-item Luganda PHQ. Of these 212 were randomly selected to respond to the Mini International Neuropsychiatric Interview diagnostic questionnaire. Descriptive statistics for respondents’ demographic characteristics and PHQ scores were generated. The sensitivity, specificity and positive predictive values (PPVs), and area under the ROC curve were determined for both the PHQ-9 and PHQ-2. The optimum trade-off between sensitivity and PPV was at a cut-off of ≧5. The weighted area under the receiver Operating Characteristic curve was 0.74 (95% CI 0.60–0.89) and 0.68 (95% CI 0.54–0.82) for PHQ-9 and PHQ-2, respectively. The Luganda translation of the PHQ-9 was found to be modestly useful in detecting depression. The PHQ-9 performed only slightly better than the PHQ-2 in this rural Ugandan Primary care setting. Future research could improve on diagnostic accuracy by considering the idioms of distress among Luganda speakers, and revising the PHQ-9 accordingly. The usefulness of the PHQ-2 in this rural population should be viewed with caution.