Depressive Symptomatology among Norwegian Adolescent Boys and Girls: The Patient Health Questionnaire-9 (PHQ-9) Psychometric Properties and Correlates.
Depressive Symptomatology among Norwegian Adolescent Boys and Girls: The Patient Health Questionnaire-9 (PHQ-9) Psychometric Properties and Correlates.
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DOI：
10.3389/fpsyg.2017.00887
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发表时间：
2017
影响因子：
3.8
通讯作者：
Brunborg GS
中科院分区：
文献类型：
--
作者：
Burdzovic Andreas J;Brunborg GS
本研究通过检查青少年学校样本（N = 846）的抑郁症状，探讨了基于精神疾病诊断和统计手册（DSM-IV）的患者健康问卷-9项目（PHQ-9）工具对挪威发展流行病学研究的潜在贡献。女孩的 PHQ-9 平均分数为 6.89 (SD = 5.13)，男孩的平均分数为 4.57 (SD = 3.98)； 8.5% 的女孩和 2.6% 的男孩被归入最初提出的重度抑郁症（MDD；PHQ-9 分数≥ 15）类别。多组验证性因素分析 (CFA) 证实了 PHQ-9 的单因素结构，具有可靠的心理测量特性和两性的高度内部一致性。然而，尽管观察到配置平等，但没有证据表明性别之间存在公制或标量平等，需要进一步调查当前挪威版本 PHQ-9 的测量等效性。我们观察到 PHQ-9 分数与青少年宗教或移民背景之间没有重大关联。此外，学校成绩、不与亲生父母住在一起以及诊断出的慢性疾病与男孩和女孩的抑郁症状升高存在不同的相关性。最后，居住不稳定、社会经济地位低、对学校不满意、缺乏亲密友谊、自杀未遂和自残史以及情绪问题严重，都与男女抑郁症的严重程度显着且一致相关。总体而言，PHQ-9 似乎是一种有前途的研究工具，除了通过连续评分捕获的症状严重程度之外，还可能提供青少年自我报告的抑郁症状的临床相关分类。然而，在 PHQ-9 在挪威用于诊断筛查之前，需要对观察到的测量不等效性进行进一步调查，以及与金标准进行全面验证和比较。
This study explored the potential contribution of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)-based Patient Health Questionnaire-9 item (PHQ-9) instrument to the developmental epidemiology research in Norway, by examining depressive symptoms in a school sample of adolescents (N = 846). The average PHQ-9 scores were 6.89 (SD = 5.13) for girls, and 4.57 (SD = 3.98) for boys; 8.5% of girls and 2.6% of boys were classified into the originally proposed categories indicative of Major Depressive Disorder (MDD; PHQ-9 scores ≥ 15). Multi-group confirmatory factor analysis (CFA) confirmed a single-factor structure for the PHQ-9 with solid psychometric properties and high internal consistency for both genders. However, even though configural equality was observed, there was no evidence for metric or scalar equality across genders, warranting further investigation of measurement equivalence for the current Norwegian version of the PHQ-9. We observed no major associations between the PHQ-9 scores and adolescent religion or immigrant background. Further, school grade, not living together with both biological parents, and diagnosed chronic illness were differently associated with elevated depressive symptoms for boys and girls. Finally, high residential instability, perceived low SES, school dissatisfaction, lack of close friendships, history of suicide attempts and self-harm, and elevated emotional problems were all significantly and consistently associated with greater depression for both genders. Overall, the PHQ-9 appears to be a promising research tool, potentially offering clinically-relevant classification of adolescent self-reported depressive symptomatology in addition to the symptom severity captured by continuous scores. Nevertheless, further investigation concerning the observed measurement non-equivalence, as well as the comprehensive validation and comparison against the gold standard is required before the PHQ-9 is to be used for diagnostic screening in Norway.