A validation study of PHQ-9 suicide item with the Columbia Suicide Severity Rating Scale in outpatients with mood disorders at National Network of Depression Centers
A validation study of PHQ-9 suicide item with the Columbia Suicide Severity Rating Scale in outpatients with mood disorders at National Network of Depression Centers
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DOI：
10.1016/j.jad.2022.09.131
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发表时间：
2022-10-13
影响因子：
6.6
通讯作者：
Selvaraj, Sudhakar
中科院分区：
文献类型：
--
作者：
Chung, Tong Han;Hanley, Kathleen;Selvaraj, Sudhakar
背景：在美国，自杀是严重的公共卫生问题之一，也是死亡的主要原因。一些研究人员和临床环境使用患者健康问卷（PHQ-9）来衡量成年人的抑郁和心理困扰，并预测自杀和死亡。本研究旨在评估PHQ-9的自杀Q9与哥伦比亚自杀严重程度评定量表（C-SSRS）相比的敏感性、特异性和预测潜力。方法：研究纳入了19岁或以上的成年人，他们在2012年至2020年期间从国家抑郁症中心网络首次就诊时被诊断为原发性心境障碍。结果：在2677名被试中，对PHQ-9自杀项目和C-SSRS回答的阳性率分别为31.6%（n = 846）和11.65%（n = 312）。PHQ-9与C-SSR相比，敏感性为74.7%，（95%CI：69.6%-79.2%），特异性74.1%（95%CI：72.3%-75.8%），阳性预测值27.5%（95%CI：24.6%-30.6%），阴性预测值95.7%（95%CI：94.7%-96.5%）。二次分析结果显示，PHQ-9自杀项目的效度结果优于C-SSRS的自杀意念项目。局限性：本研究是在心境障碍患者中进行的，因此需要在不同条件的人群中进行额外的研究。对于初步的自杀筛查，PHQ-9自杀项目将过度识别患者有自杀风险，C-SSRS应用于情绪障碍诊所识别自杀风险。
Background: In the United States, suicide is one of the serious public health problems and a major cause of death. Several researchers and clinical settings use the patient health questionnaires (PHQ-9) to gauge depression and psychological distress among adults and to predict suicide and death. This study aimed to assess the sensitivity, specificity, and predictive potential of suicide Q9 of the PHQ-9 compared to the Columbia-suicide severity rating scale (C-SSRS).Methods: Adults aged 19 or older, identified with a primary mood disorder diagnosis during their initial clinic visit between 2012 and 2020 from the National Network of Depression Centers, were included in the study. The accuracy of the PHQ-9 suicide item was compared with the gold standard, the C-SSRS.Results: Out of 2677 study participants, 31.6 % (n = 846) and 11.65 % (n = 312) had positive responses to the PHQ-9 suicide item and C-SSRS response, respectively. The sensitivity of the PHQ-9 compared to the C-SSR was 74.7 % (95%CI: 69.6 %-79.2 %), specificity 74.1 % (95%CI: 72.3 %-75.8 %), positive predictive value 27.5 % (95%CI: 24.6 %-30.6 %), and negative predictive value 95.7 % (95%CI: 94.7 %-96.5 %). The secondary analysis results showed better validity results of the PHQ-9 suicide item when compared to the suicide ideation item of the C-SSRS.Limitations: This study is among mood disorder patients so additional research would be necessary among populations with different conditions.Conclusion: For initial suicide screening, the PHQ-9 suicide item would over identify patients as at risk for suicide and the C-SSRS should be used mood disorder clinics to identify suicide risk.