Validity of the Patient Health Questionnaire (PHQ)-9 and PHQ-2 in general internal medicine primary care at a Japanese rural hospital: a cross-sectional study
Validity of the Patient Health Questionnaire (PHQ)-9 and PHQ-2 in general internal medicine primary care at a Japanese rural hospital: a cross-sectional study
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DOI：
10.1016/j.genhosppsych.2013.08.001
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发表时间：
2013-11-01
影响因子：
7
通讯作者：
Yamada, Mitsuhiko
中科院分区：
文献类型：
--
作者：
Inagaki, Masatoshi;Ohtsuki, Tsuyuka;Yamada, Mitsuhiko
目的：两种抑郁症筛查工具，即患者健康问卷 (PHQ)-9 和 PHQ-2，尚未在日本普通内科环境中进行有效性检验。我们检验了这些筛查工具的有效性。方法：连续纳入某乡村综合医院内科门诊的598例门诊患者，并按PHQ-9评分进行分层。随机选择的 75 名患者和 PHQ-9 结果被认为患有抑郁症的 29 名患者接受了半结构化访谈，即小型国际神经精神病学访谈。我们使用多重插补的采样权重，计算了 PHQ-9 和 PHQ-2 检测重度抑郁症的诊断准确性，以及 PHQ-9 自杀项目检测自杀的诊断准确性。结果：PHQ-9 的抑郁症敏感性和特异性分别为 0.86 和 0.85，截止点为 4/5；对于自杀性抑郁症，PHQ-9 的敏感性和特异性分别为 0.86 和 0.95。 PHQ-2，截止点为 2/3。 PHQ-9 自杀项目的敏感性和特异性分别为 0.70 和 0.97。结论：在日本乡村医院的内科诊所中，可以推荐每个设置具有最佳截止点的 PHQ-2 加上 PHQ-9 的自杀项目来检测抑郁症，而不会遗漏自杀。 (C) 2013 Elsevier Inc. 保留所有权利。
Objective: Two depression screening tools, Patient Health Questionnaire (PHQ)-9 and PHQ-2, have not had their validity examined in general internal medicine settings in Japan. We examined the validity of these screening tools.Methods: A total of 598 outpatients of an internal medicine clinic in a rural general hospital were enrolled consecutively and stratified by PHQ-9 score. Seventy-five patients randomly selected and 29 patients whose results from the PHQ-9 were considered to be positive for depressive disorder were then interviewed with a semistructured interview, the Mini International Neuropsychiatric Interview. We calculated diagnostic accuracy of the PHQ-9 and PHQ-2 to detect major depression and that of the suicidality item of the PHQ-9 to detect suicidality using sampling weights with multiple imputations.Results: Sensitivity and specificity for depression were 0.86 and 0.85, respectively, for the PHQ-9 with cutoff points of 4/5, and 0.77 and 0.95, respectively, for the PHQ-2 with cutoff points of 2/3. Sensitivity and specificity of the suicidality item of the PHQ-9 were 0.70 and 0.97, respectively.Conclusion: In internal medicine clinics in Japanese rural hospitals, the PHQ-2 with an optimal cutoff point for each setting plus the suicidality item of the PHQ-9 can be recommended to detect depression without missing suicidality. (C) 2013 Elsevier Inc. All rights reserved.