How reliable is depression screening in alcohol and drug users? A validation of brief and ultra-brief questionnaires
How reliable is depression screening in alcohol and drug users? A validation of brief and ultra-brief questionnaires
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DOI：
10.1016/j.jad.2011.06.017
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发表时间：
2011-11-01
影响因子：
6.6
通讯作者：
Dale, Veronica
中科院分区：
文献类型：
--
作者：
Delgadillo, Jaime;Payne, Scott;Dale, Veronica
背景：抑郁症与酒精和药物问题高度并存，导致更大的损害，降低治疗依从性和不良结局。几乎没有证据支持在常规成瘾治疗中使用精神健康筛查工具。本研究对PHQ-9和PHQ-2作为抑郁症病例发现工具在英国门诊药物治疗样本中的效度和信度进行了检验。方法：对103例患者进行CIS-R诊断评估，并完成简短的筛选问卷。一个由60名患者组成的小组在4周后完成了重新测试。将诊断结果与使用受试者工作特征(ROC)曲线的简单测量进行比较。结果：PHQ-9总分=12分对抑郁症的敏感度为81%，特异度为75%，具有良好的重测信度(班内相关系数0.78)和内部一致性(Cronbach‘sα系数0.84)。PHQ-2具有68%的敏感性和70%的特异性，重测信度(0.66)和内部一致性(0.64)较低。限制：诊断性访谈没有考虑药物使用和心理健康问题的时间顺序。结论：PHQ-9是一种有效和可靠的抑郁筛查工具。自我完成的问卷简明扼要，易于管理，这使它们成为成瘾服务中有用的临床工具，通常遇到高患病率的抑郁症。(C)2011爱思唯尔B.V.保留所有权利。
Background: Depression is highly comorbid with alcohol and drug problems, resulting in greater impairment, reduced treatment adherence and poor outcomes. Little evidence exists to support the use of mental health screening tools in routine addiction treatment. This study tested the validity and reliability of PHQ-9 and PHQ-2 as depression case finding tools in an outpatient drug treatment sample in the United Kingdom.Methods: A sample of 103 patients took part in diagnostic assessments using CIS-R and completed brief screening questionnaires. A subgroup of 60 patients completed retests after 4 weeks. Diagnostic results were compared to brief measures using receiver operating characteristic (ROC) curves. Psychometric properties were also calculated to evaluate the validity and reliability of self-completed questionnaires.Results: A PHQ-9 score >= 12 had a sensitivity of 81% and specificity of 75% for major depression, also displaying good retest reliability (intra-class correlation, 0.78) and internal consistency (Cronbach's alpha, 0.84). PHQ-2 had 68% sensitivity and 70% specificity, with more modest retest reliability (0.66) and internal consistency (0.64).Limitations: Diagnostic interviews did not consider the temporal sequencing of the onset of drug use and mental health problems.Conclusions: PHQ-9 is a valid and reliable depression screening tool for drug and alcohol users. The brevity and ease of administration of self-completed questionnaires make them useful clinical tools in addiction services commonly encountering a high prevalence of depression. (C) 2011 Elsevier B.V. All rights reserved.