How do the phq-2, the phq-9 perform in aging services clients with cognitive impairment?
How do the phq-2, the phq-9 perform in aging services clients with cognitive impairment?
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DOI：
10.1002/gps.2632
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发表时间：
2011-09-01
影响因子：
4
通讯作者：
Conwell, Yeates
中科院分区：
文献类型：
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作者：
Boyle, Lisa L.;Richardson, Thomas M.;Conwell, Yeates
目的：探讨老年人健康问卷-2 （PHQ-2）和PHQ-9在认知功能障碍（CI）筛查呈阳性的老年服务护理管理客户当前重性抑郁发作（MDE）中的表现。方法：横断面观察研究236名护理管理客户年龄bb0 = 60岁从纽约州北部的老龄化服务机构招募。使用DSM-IV （SCID）结构化临床访谈（Structured Clinical Interview for DSM-IV）计算PHQ-2和PHQ-9筛查抑郁症的测试特征，以确定MDE（金标准）。CI是通过六项筛选（SIS）确定的。结果：参与者的平均年龄为77岁，68%为女性，16%为非白人，26%为高中以下教育程度。16%的参与者在SIS上有>= 2错误识别CI。其中，41% PHQ-2阳性（评分>= 3），43% PHQ-9阳性（评分>= 10），24%符合MDE标准。在有CI的样本中，PHQ-2的灵敏度= 0.78，特异性= 0.71，受试者工作特征（ROC）曲线下面积(AUC) = 0.81，而无CI的样本分别为0.79,0.82和0.88。在有CI的样本中，PHQ-9（截止值为10）的敏感性= 0.89，特异性= 0.71,AUC = 0.85，而在没有CI的样本中，PHQ-9的灵敏度分别为0.85,0.89和0.91。结论：在使用PHQ作为抑郁症筛查时应考虑认知状态，因为老年人CI的特异性较差。版权所有John Wiley & Sons， Ltd。
Objective: To examine the performance of the Patient Health Questionnaire-2 (PHQ-2) and the PHQ-9 in detecting current major depressive episode (MDE) in aging services care management clients who screen positive for cognitive impairment (CI).Methods: Cross-sectional observational study of 236 care management clients ages >= 60 years recruited from an Upstate NY aging services agency. The test characteristics of the PHQ-2 and PHQ-9 to screen for depression were calculated using the Structured Clinical Interview for DSM-IV (SCID) to identify MDE (gold standard). CI was identified with the Six-Item Screen (SIS).Results: Participants had a mean age of 77 years, 68% female, 16% non-white, and 26% had less than a high school education. 16% of participants had CI identified by >= 2 errors on SIS. Of these, 41% had positive PHQ-2 (scores >= 3), 43% had positive PHQ-9 (scores >= 10), while 24% met criteria for MDE. In the sample with CI, the PHQ-2, using a cutoff of 3, had sensitivity = 0.78, specificity = 0.71, and receiver operating characteristic (ROC) area under the curve (AUC) = 0.81, compared with 0.79, 0.82, and 0.88, respectively, for those without CI. In the sample with CI, the PHQ-9, using a cutoff of 10, had sensitivity = 0.89, specificity = 0.71, and AUC = 0.85, compared with 0.85, 0.89, and 0.91, respectively, for those without CI.Conclusions: Cognitive status should be considered when using the PHQ as a depression screener due to poorer specificity in seniors with CI. Copyright (C) 2010 John Wiley & Sons, Ltd.