Influence of Somatic Symptoms on Patient Health Questionnaire-9 Depression Scores Among Patients With Systemic Sclerosis Compared to a Healthy General Population Sample
Influence of Somatic Symptoms on Patient Health Questionnaire-9 Depression Scores Among Patients With Systemic Sclerosis Compared to a Healthy General Population Sample
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DOI：
10.1002/acr.21675
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发表时间：
2012-08-01
影响因子：
4.7
通讯作者：
Thombs, Brett D.
中科院分区：
文献类型：
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作者：
Leavens, Allison;Patten, Scott B.;Thombs, Brett D.
Objective.包括躯体症状在内的抑郁症状测量可能会夸大医学疾病患者（包括系统性硬化症（SSc;硬皮病）患者）的严重程度估计。9项患者健康问卷（PHQ-9）越来越多地用于评估医疗环境中的抑郁症状，但尚不清楚PHQ-9评分是否受到医学疾病中常见的躯体症状的影响。目的是评估SSc患者在PHQ-9上的躯体症状评分是否高于来自一般人群的认知/情感评分匹配的非医学疾病应答者。将来自加拿大硬皮病研究组登记处的SSc患者与来自加拿大阿尔伯塔居民的随机人群调查的无慢性疾病的受访者在PHQ-9认知/情感总分（5项）、性别和尽可能接近的年龄方面进行匹配。比较SSc患者和健康阿尔伯塔调查受访者的PHQ-9躯体评分（4项），使用t检验进行未校正分析，使用协方差分析校正匹配后的年龄差异。躯体症状占762例匹配SSc患者（共837例）PHQ-9总评分的64%，而762例匹配阿尔伯塔人口调查受访者（共3，304例）为56%，平均差异为1.0分，占SSc患者总评分的19%（Hedges g = 0.38）。校正年龄后，平均差异增加到1.4分，反映了25%的SSc患者的总分（Hedges的g = 0.55）。SSc患者的PHQ-9评分可能包括与不一定与抑郁相关的躯体症状的小到中等程度的差异。
Objective. Depression symptom measures that include somatic symptoms may inflate severity estimates among medically ill patients, including patients with systemic sclerosis (SSc; scleroderma). The 9-item Patient Health Questionnaire (PHQ-9) is increasingly used to assess depressive symptoms in medical settings, but it is not known whether PHQ-9 scores are influenced by somatic symptoms common in medical illness. The objective was to assess whether SSc patients had higher somatic symptom scores on the PHQ-9 than non-medically ill respondents from the general population matched on cognitive/affective scores.Methods. SSc patients from the Canadian Scleroderma Research Group Registry were matched with respondents from a random population survey of Alberta, Canada residents who were without chronic disease on total PHQ-9 cognitive/affective scores (5 items), sex, and, as close as possible, age. PHQ-9 somatic scores (4 items) were compared between SSc patients and healthy Alberta survey respondents using t-tests for unadjusted analyses and analysis of covariance to adjust for age differences that remained after matching.Results. Somatic symptoms accounted for 64% of the total PHQ-9 scores for 762 matched SSc patients (n = 837 total) compared to 56% for 762 matched Alberta population survey respondents (n = 3,304 total), a mean difference of 1.0 point, or 19% of the total scores for the SSc patients (Hedges's g = 0.38). After adjusting for age, the mean difference increased to 1.4 points, reflecting 25% of the SSc patients' total scores (Hedges's g = 0.55).Conclusion. PHQ-9 scores among patients with SSc may include a small to moderate amount of variance from somatic symptoms that are not necessarily related to depression.