The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms
The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms
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DOI：
10.1097/00006842-200203000-00008
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发表时间：
2002-03-01
影响因子：
3.3
通讯作者：
Williams, JBW
中科院分区：
文献类型：
--
作者：
Kroenke, K;Spitzer, RL;Williams, JBW
目的：躯体化是普遍存在于初级保健，并与实质性的功能障碍和医疗保健利用。然而，用于识别和监测躯体症状的仪器数量很少，并且没有广泛使用。因此，我们研究了躯体症状严重程度的简单测量的有效性。方法：患者健康问卷（PHQ）是PRIME-MD常见精神障碍诊断工具的自填版本。PHQ-15包括来自PHQ的15种躯体症状，每种症状的评分从0（“完全不困扰”）到2（“困扰很多”）。PHQ-15在8个普通内科和家庭诊所以及7个妇产科诊所对6000名患者进行了管理。结果包括通过20项简式一般健康调查（SF-20）评估的功能状态，自我报告的病假和门诊访视，以及与糖尿病相关的困难。结果：随着PHQ-15躯体症状严重程度的增加，SF-20所有6个分量表的功能状态呈显著的逐步下降。此外，与医疗有关的困难、病假和医疗保健利用率也有所增加。PHQ-15评分5、10、15分别代表低、中和高躯体症状严重程度的截止点。躯体症状和抑郁症状的严重程度对结果有不同的影响。结果在初级保健和妇产科样本中相似。结论：PHQ-15是一个简短的，自我管理的问卷，可能是有用的筛选躯体化和监测躯体症状的严重程度在临床实践和研究。
Objective: Somatization is prevalent in primary care and is associated with substantial functional impairment and healthcare utilization. However, instruments for identifying and monitoring somatic symptoms are few in number and not widely used. Therefore, we examined the validity of a brief measure of the severity of somatic symptoms. Methods: The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-15 comprises 15 somatic symptoms from the PHQ, each symptom scored from 0 ("not bothered at all") to 2 ("bothered a lot"). The PHQ-15 was administered to 6000 patients in eight general internal medicine and family practice clinics and seven obstetrics-gynecology clinics. Outcomes included functional status as assessed by the 20-item Short-Form General Health Survey (SF-20), self-reported sick days and clinic visits, and symptom-related difficulty. Results: As PHQ-15 somatic symptom severity increased, there was a substantial stepwise decrement in functional status on all six SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. PHQ-15 scores of 5, 10, 15, represented cutoff points for low, medium, and high somatic symptom severity, respectively. Somatic and depressive symptom severity had differential effects on outcomes. Results were similar in the primary care and obstetrics-gynecology samples. Conclusions: The PHQ-15 is a brief, self-administered questionnaire that may be useful in screening for somatization and in monitoring somatic symptom severity in clinical practice and research.