Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people
Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people
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DOI：
10.1111/j.1532-5415.2007.01103.x
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发表时间：
2007-04-01
影响因子：
6.3
通讯作者：
Fiscella, Kevin
中科院分区：
文献类型：
--
作者：
Li, Chunyu;Friedman, Bruce;Fiscella, Kevin
目的：以精神疾病诊断和统计手册第四版(DSM-IV)为标准，确定患者健康问卷2(PHQ-2)在诊断重度抑郁症的标准中的表现，并检验其在年龄、性别和种族/民族群体中的表现。设计：横断面观察性研究。收集：全国酒精及相关疾病流行病学调查(NESARC)(2001/02)，一项具有全国代表性的美国非制度化家庭人口调查。样本：8,205名65岁及以上的成年人参加NESARC.测量：PHQ-2的S标准的效度(敏感度、特异度、特异度)结果：PHQ-2‘S标准对抑郁症的诊断效度良好(灵敏度为100%，特异度为77%，AUC为0.88)。对各亚组的敏感性均为100%。特异性随着年龄的增长而增加，男性比女性更高，并且在种族和民族之间存在差异。对于总样本和性别，使用PHQ-2检测呈阳性的人的所有六个SF-12量表都明显较低。结论：PHQ-2是一种有效的老年抑郁症筛查工具，但应遵循更全面的诊断程序。尽管其特异性因年龄、性别、种族和民族的不同而不同，但这些差异似乎没有临床意义。
OBJECTIVES: To determine the performance of the Patient Health Questionnaire 2 (PHQ-2) against the criterion standard for diagnosing major depression, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and to examine its performance across age, sex, and racial/ethnic groups.DESIGN: Cross-sectional observational study.SETTING: The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (2001/02), a nationally representative survey of the noninstitutionalized U.S. household population.PARTICIPANTS: The 8,205 adults aged 65 and older who participated in NESARC.MEASUREMENTS: The PHQ-2's criterion validity (sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) against the DSM-IV) and construct validity (Spearman correlations between the PHQ-2 and the six scales of the Medical Outcomes Study 12-item Short Form Questionnaire (SF-12)) were calculated.RESULTS: The PHQ-2's criterion validity for major depression was good (sensitivity = 100%, specificity = 77%, AUC = 0.88). Its sensitivity was 100% for each subgroup. Specificity increased with age, was higher for men than for women, and differed across racial and ethnic groups. For the total sample and each sex, all six SF-12 scales were significantly lower in people who tested positive using the PHQ-2. For each age and racial or ethnic group, most of the six scales differed significantly between those who tested positive and tested negative.CONCLUSION: The PHQ-2 is a valid screening tool for major depression in older people but should be followed by a more-comprehensive diagnostic process. Although its specificity differs by age, sex, and racial and ethnic groups, these differences appear to be of little clinical significance.