Sequential screening for depression in humanitarian emergencies: a validation study of the Patient Health Questionnaire among Syrian refugees
Sequential screening for depression in humanitarian emergencies: a validation study of the Patient Health Questionnaire among Syrian refugees
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DOI：
10.1186/s12991-020-0259-x
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发表时间：
2020-02-03
影响因子：
3.7
通讯作者：
Fawzi, Mary C. Smith
中科院分区：
文献类型：
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作者：
Poole, Danielle N.;Liao, Shirley;Fawzi, Mary C. Smith
背景 尽管在人道主义紧急情况下需要进行心理健康监测，但仍缺乏经过验证的工具。本研究使用两项和八项患者健康问卷（分别为 PHQ-2 和 PHQ-8）评估了重度抑郁症 (MDD) 的顺序筛查过程。方法 本研究分析了在希腊叙利亚难民营进行的横断面调查中收集的数据（n = 135）。评估每种工具的答复率，并将答复负担计算为完成的项目数。如果使用 PHQ-2 来缩小接受完整 PHQ-8 评估的人群范围，则模拟连续筛选过程以复制捕获的 MDD 分类。所有受访者均使用 PHQ-2 进行筛查。只有得分 >= 2 的受访者才被视为有 MDD 症状的风险，并完成其余六项。评估了该连续筛选过程的阳性和阴性百分比一致性。结果 PHQ-2、PHQ-2/8 顺序筛选过程和 PHQ-8 的受访者分别完成了 91%、87% 和 84%。顺序筛选过程的阳性一致性百分比为 89%，阴性一致性百分比为 100%，并且无需为 34 名 (25%) 受访者完成完整的 PHQ-8 量表。结论 这里介绍的 MDD 分类序贯筛选方法有双重好处：相对于单独的 PHQ-2 保持分类准确性，同时减少 PHQ-8 的响应负担。这种顺序筛查方法是简化人道主义紧急情况下 MDD 监测的务实策略。
Background Despite the need for mental health surveillance in humanitarian emergencies, there is a lack of validated instruments. This study evaluated a sequential screening process for major depressive disorder (MDD) using the two- and eight-item Patient Health Questionnaires (PHQ-2 and PHQ-8, respectively). Methods This study analyzed data collected during a cross-sectional survey in a Syrian refugee camp in Greece (n = 135). The response rate for each instrument was assessed, and response burden was calculated as the number of items completed. The sequential screening process was simulated to replicate the MDD classifications captured if the PHQ-2 was used to narrow the population receiving the full PHQ-8 assessment. All respondents were screened using the PHQ-2. Only respondents scoring >= 2 are considered at risk for symptoms of MDD and complete the remaining six items. The positive and negative percent agreement of this sequential screening process were evaluated. Results The PHQ-2, PHQ-2/8 sequential screening process, and PHQ-8 were completed by 91%, 87%, and 84% of respondents, respectively. The sequential screening process had a positive percent agreement of 89% and a negative percent agreement of 100%, and eliminated the need to complete the full PHQ-8 scale for 34 (25%) respondents. Conclusions The benefits of the sequential screening approach for the classification of MDD presented here are twofold: preserving classification accuracy relative to the PHQ-2 alone while reducing the response burden of the PHQ-8. This sequential screening approach is a pragmatic strategy for streamlining MDD surveillance in humanitarian emergencies.