Validation of the Patient Health Questionnaire-9 (PHQ-9) for Detecting Depression Among Pregnant Women in Lima, Peru.
Validation of the Patient Health Questionnaire-9 (PHQ-9) for Detecting Depression Among Pregnant Women in Lima, Peru.
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DOI：
10.1007/s12144-020-00882-2
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发表时间：
2022-06
影响因子：
2.8
通讯作者：
Gelaye, Bizu
中科院分区：
文献类型：
--
作者：
Smith, Meghan L;Sanchez, Sixto E;Rondon, Marta;Gradus, Jaimie L;Gelaye, Bizu
怀孕期间的抑郁症与不良的围产期和后代结果有关。患者健康问卷-9（PHQ-9）已被验证用于在有限的文化背景下识别孕妇的抑郁症。结构效度和可靠性已在秘鲁利马进行了评估，但标准效度没有。本研究旨在全面评价妊娠结局、母婴研究（PrOMIS）中秘鲁孕妇的PHQ-9。使用复合国际诊断访谈（CIDI）标准为过去12个月的重性抑郁症作为参考标准，敏感性，特异性和预测值的PHQ-9检测抑郁症进行了评估，在不同的切割点的PHQ-9。使用验证性因素分析（CFA）来评估PHQ-9的单因素和双因素结构。计算整个PHQ-9量表和CFA支持的子量表的Cronbach α。≥8的临界点使联合灵敏度（61%）和特异性（62%）最大化。在该临界点，阳性预测值较低（15%），阴性预测值较高（93%）。全量表的可靠性较高（α=0.80）。单因素和双因素解决方案都适用于该人群，但包含情感/情绪因素（α=0.67）和躯体因素（α=0.75）的双因素解决方案是最佳的（CFI=0.93，RMSEA=0.075）。在利马的孕妇中，使用PHQ-9进行筛查可以确定那些需要精神卫生保健的人，但可能会发现大量假阳性病例。
Depression during pregnancy is linked to adverse perinatal and offspring outcomes. The Patient Health Questionnaire-9 (PHQ-9) has been validated for identifying depression in pregnant women in limited cultural contexts. Construct validity and reliability have been assessed in Lima, Peru, but criterion validity has not. This study aimed to comprehensively evaluate the PHQ-9 among pregnant Peruvian women in the Pregnancy Outcomes, Maternal and Infant Study (PrOMIS). Using Composite International Diagnostic Interview (CIDI) criteria for past-12-month major depressive disorder as the reference standard, sensitivity, specificity, and predictive value of the PHQ-9 for detecting depression were assessed at various cutpoints of the PHQ-9. Confirmatory factor analysis (CFA) was used to evaluate one- and two-factor structures for the PHQ-9. Cronbach’s alpha was computed for the entire PHQ-9 scale and for subscales supported by CFA. A cutpoint of ≥8 maximized combined sensitivity (61%) and specificity (62%). At this cutpoint, positive predictive value was low (15%) and negative predictive values was high (93%). Reliability for the full scale was high (α=0.80). Both one- and two-factor solutions were appropriate for this population, but a two-factor solution containing an affective/mood factor (α=0.67) and a somatic factor (α=0.75) was optimal (CFI=0.93, RMSEA=0.075). Among pregnant women in Lima, screening with the PHQ-9 can identify those in need of mental health care, but may identify a large number of false positive cases.