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患者健康问卷抑郁量表在综合医院心身疾病门诊的应用 被引量:38

Application of patient health questionnaire-9 in psychosomatic disease outpatients in a general hospital
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摘要 目的 探讨患者健康问卷抑郁量表(patient health questionnaire-9,PHQ-9)在综合医院心身疾病门诊对抑郁筛查的可行性并分析抑郁发生的相关因素.方法 258例患者自行完成PHQ-9及世界卫生组织生活质量测定量表简表(the world health questionnaire quality of life brief questionnaire,WHOQOL-BREF)的评估并接受汉密尔顿抑郁量表(Hamilton depression rating sca-le,HAMD-17)评定.抽取其中97例患者进行美国精神障碍诊断与统计手册DSM-Ⅳ轴Ⅰ障碍临床定式检查(structured clinical interview for DSM-Ⅳaxis Ⅰ disorders,SCID),进行PHQ-9的效度研究.按PHQ-9是否≥5分分为有抑郁症状群组和无抑郁症状群组,分析抑郁发生的相关因素.结果 ①PHQ-9的特异度为67%,灵敏度为98%,Kappa值为0.664.PHQ-9总分与HAMD总分显著相关,相关系数为0.75 (P<0.01).②单因素分析发现年龄、家庭人均月收入、对自己当前的健康状况满意程度、生存质量满意程度与抑郁的发生有关.多因素Logistic回归分析显示:年龄、健康状况、生活质量是影响抑郁发生的主要因素.结论 PHQ-9可作为抑郁症状的筛查工具以提高抑郁识别率.年龄、健康状况、生存质量是影响抑郁发生的主要因素. Objective To explore the feasibility of patient health questionnaire-9 (PHQ-9) in a general hospital outpatients and analyze the risk factors of depressive syndromes.Methods Two hundred fifty-eight outpatients filled out PHQ-9 and the World Health Questionnaire Quality of Life Brief Questionnaire(WHOQOL-BREF) by themselves.Then they were evaluated by professionals with Hamilton Depression Rating Scale (HAMD-17).Ninety-seven of them were further interviewed with the Structured Clinical Interview for DSM-Ⅳ Disorders(SCID) for the diagnosis of major depression which in order to analyze the validity of the PHQ-9.All patients were divided into the depressive group and non-depressive group according the score of PHQ-9,and then analyzed the risk factors of depression.Results ①The sensitivity of PHQ-9 was 98%,the specificity was 67% and Kappa was 0.664.The total score of PHQ-9 was high correlated with the total score of HAMD,the coefficient was 0.75(P<0.01).②The Univariate analysis showed that the depressive symptom was associated with age,monthly income,health status,the quality of life.Logistic regression analysis showed that age,health status,the quality of life were the main factors of depression.Conclusion PHQ-9 may svere as a screening tool to increase the recognition of depression and age,health status,the quality of life were the main factors of depression.
出处 《中华行为医学与脑科学杂志》 CAS CSCD 北大核心 2015年第5期473-476,共4页 Chinese Journal of Behavioral Medicine and Brain Science
基金 北京市科技计划项目(D101107047810001,D121100005012002) 山西省科技攻关项目(20110313012-1)
关键词 患者健康问卷抑郁量表 综合医院 抑郁症状 Patient health questionnaire-9 General hospital Depressive symptoms
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