摘要
目的 评估9条目患者健康问卷（PHQ-9）以及2条目患者健康问卷（PHQ-2）在心血管门诊患者中抑郁障碍筛查的信度和效度.方法 2013年6月至2014年1月于重庆医科大学附属第一医院和北京大学人民医院双心门诊连续纳入的201例患者作为研究对象.患者自主完成pHQ-9问卷,并根据精神疾病诊断与统计手册-Ⅳ轴Ⅰ障碍临床定式访谈（CIDI）进行心理状态评估.1周后,采用随机数字表法选择50例检验PHQ-9问卷的重测信度.以CIDI作为诊断标准,评估PHQ-2和PHQ-9内容效度.结果 根据CIDI诊断标准,纳入对象中42例（21.3％）被诊断为临床抑郁.以10分为诊断界值,PHQ-9诊断抑郁的敏感度和特异度分别为87.1％和83.5％,阳性预测值和阴性预测值分别为58.7％和95.6％,ROC曲线下面积（AUC）为0.877（SE=0.032,95％ CI：0.813 ～0.938）,内部一致性系数为0.809,重测信度系数为0.882.以3分为诊断界值,PHQ-2诊断抑郁的灵敏度和特异度分别是85.7％与69.2％,阳性预测值和阴性预测值分别为57.7％为93.6％,AUC为0.806（SE=0.042,95％CI：0.774 ～0.889）,内部一致性系数为0.785,重测信度系数为0.813.结论 PHQ-2和PHQ-9是心血管门诊患者中抑郁障碍可靠和有效的筛查工具,有较高的排除诊断价值,值得在心血管门诊患者中推广应用.
Objective To analyze the value of 2-and 9-question patient health questionnaires （PHQ-2 and PHQ-9） for screening status of depression in cardiovascular outpatients.Methods From June 2013 to January 2014,a total of 201 outpatients from psycho-cardiological outpatients departments were consecutively enrolled into this study.All patients were asked to complete PHQ-9 and the mental psychological assessment by qualified researchers trained by psychiatry according to the composite international diagnostic interviews （CIDI）,50 cases were retested to assess the retest reliability after one week.The PHQ-2 and PHQ-9 were validated with the CIDI as the reference criteria.Results According to the CIDI,42（21.3％） out of the 201 outpatients were diagnosed as depression.For PHQ-9 scale,a cutoff value of 10 presented satisfactory results with 87.1％ sensitivity,83.5％ specificity,58.7％ positive predicting value,95.6％ negative predicting value and the area under the ROC curve （AUC） was 0.877 （SE =0.032,95％ CI：0.813-0.938）.The Cronbach＇s alpha coefficients and test-retest reliability of the PHQ-9 were 0.809 and 0.882,respectively.Compared with CIDI,the cutoff value of the PHQ-2 was 3 with 85.7％ sensitivity,69.2％ specificity,57.1％ positive predicting value,93.6％ negative predicting value,and the AUC was 0.806（SE =0.042,95％ CI：0.774-0.889）.The Cronbach＇s alpha coefficients and testretest reliability of the PHQ-2 were 0.785 and 0.813,respectively.Conclusion The PHQ-2 and PHQ-9 are reliable and efficient instruments for screening and especially excluding depression in cardiovascular outpatients.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2015年第5期428-431,共4页
Chinese Journal of Cardiology
基金
北京市自然科学基金（7132199）
关键词
心血管疾病
抑郁
心理学试验
Cardiovascular diseases
Depression
Psychological tests
