A study of the diagnostic accuracy of the PHQ-9 in primary care elderly
A study of the diagnostic accuracy of the PHQ-9 in primary care elderly
复制标题
DOI：
10.1186/1471-2296-11-63
复制
发表时间：
2010-09-01
影响因子：
2.9
通讯作者：
Snowden, Mark
中科院分区：
文献类型：
--
作者：
Phelan, Elizabeth;Williams, Barbara;Snowden, Mark
背景：患者健康问卷-9 （PHQ-9）用于评估美国初级保健机构中老年人抑郁症的诊断准确性尚未得到解决。因此，本研究的目的是评估PHQ-9在初级保健中检测老年患者重度和轻度抑郁的测试性能。方法：在美国太平洋西北地区的两个初级保健大学诊所进行了诊断准确性的前瞻性研究。71名65岁及以上的患者参与了研究；所有患者均完成了PHQ-9和15项老年抑郁量表（GDS），并接受了抑郁症结构化临床访谈（SCID）。计算PHQ-9、PHQ-2和15项GDS对单独重度抑郁和重度+轻度抑郁的敏感性、特异性、受试者工作特征曲线下面积和似然比。结果：三分之二的参与者是女性，平均年龄为78岁，患有两种慢性疾病。12%的人符合重度抑郁症的SCID标准，13%的人符合轻度抑郁症的标准。重度抑郁症PHQ-9的曲线下面积（AUC）为0.87(95%可信区间[CI]， 0.74-1.00)，而PHQ-2和15项GDS的AUC均为0.81 （PHQ-2的95% CI为0.64-0.98,15项GDS的95% CI为0.70-0.91,P = 0.551）。对于重度和轻度抑郁症合并，PHQ-9的AUC为0.85 (95% CI, 0.73-0.96)， PHQ-2的AUC为0.80 (95% CI, 0.68-0.93)， 15项GDS的AUC为0.71 （95% CI, 0.55-0.87; P = 0.187）。结论：基于AUC值，PHQ-9与PHQ-2和15项GDS在识别初级保健老年人抑郁症方面的效果相当。
Background: The diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depression in elderly persons in primary care settings in the United States has not been previously addressed. Thus, the purpose of this study was to evaluate the test performance of the PHQ-9 for detecting major and minor depression in elderly patients in primary care.Methods: A prospective study of diagnostic accuracy was conducted in two primary care, university-based clinics in the Pacific Northwest of the United States. Seventy-one patients aged 65 years or older participated; all completed the PHQ-9 and the 15-item Geriatric Depression Scale (GDS) and underwent the Structured Clinical Interview for Depression (SCID). Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, and likelihood ratios (LRs) were calculated for the PHQ-9, the PHQ-2, and the 15-item GDS for major depression alone and the combination of major plus minor depression.Results: Two thirds of participants were female, with a mean age of 78 and two chronic health conditions. Twelve percent met SCID criteria for major depression and 13% minor depression. The PHQ-9 had an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.74-1.00) for major depression, while the PHQ-2 and the 15-item GDS each had an AUC of 0.81 (95% CI for PHQ-2, 0.64-0.98, and for 15-item GDS, 0.70-0.91; P = 0.551). For major and minor depression combined, the AUC for the PHQ-9 was 0.85 (95% CI, 0.73-0.96), for the PHQ-2, 0.80 (95% CI, 0.68-0.93), and for the 15-item GDS, 0.71 (95% CI, 0.55-0.87; P = 0.187).Conclusions: Based on AUC values, the PHQ-9 performs comparably to the PHQ-2 and the 15-item GDS in identifying depression among primary care elderly.