病人健康问卷在综合医院精神科门诊中筛查抑郁障碍的诊断试验

发布时间：2018-05-13 16:44

本文选题：条目病人健康问卷 + 效度　；参考：《中国心理卫生杂志》2015年04期

【摘要】：目的:用诊断试验探讨9条目病人健康问卷(PHQ-9)对抑郁障碍的筛查功能,检验其对不同严重程度抑郁症的划界值。方法:选取综合医院精神科就诊者319例,包括80例不符合任何精神科诊断的咨询者和239例精神障碍患者。所有受试均完成PHQ-9自评,以用简明国际神经精神访谈(M.I.N.I.)评估做抑郁障碍诊断为"金标准",用汉密顿抑郁量表(HAMD)评估病情严重程度。结果:因子分析显示PHQ-9有较好的结构效度。符合抑郁障碍诊断46例,PHQ-9评分的ROC曲线下面积0.94(95%CI:0.91~0.97);以15分为划界值时综合医院精神科门诊患者的抑郁障碍筛查的敏感度和特异度分别为83%和90%。以HAMD为标准,PHQ-9对轻度、中度、重度抑郁症的划界值为6分、12分、15分,以此划界值得出的PHQ-9等级和HAMD得出的严重程度的一致性评价kappa值为0.49;以量表制定者推荐的5、10、15分得出的PHQ-9等级和HAM D得出的症状程度的kappa值为0.46。PHQ-9的内部一致性系数为0.89。结论:9条目病人健康问卷具有良好的效度和信度,可用于综合医院中对抑郁障碍初筛和严重程度评估。量表制定者推荐的划界值适用于国内综合医院精神科抑郁障碍患者。
[Abstract]:Objective: to investigate the screening function of 9 items of patient health questionnaire (PHQ-9) for depressive disorder and to test its boundary value for depression of different severity by diagnostic test. Methods: 319 psychiatric patients were selected, including 80 counselors who did not meet any psychiatric diagnosis and 239 patients with mental disorders. All subjects completed PHQ-9 self-assessment for brief international neuropsychiatric interviews (M.I.N.I.) To evaluate the severity of depressive disorder by using Hamilton Depression scale (Hamd). Results: factor analysis showed that PHQ-9 had good structural validity. The area under the ROC curve of 46 patients with depressive disorder diagnosed by PHQ-9 score was 0.9495% CI: 0.91U 0.970.The sensitivity and specificity of depressive disorder screening in psychiatric outpatients were 83% and 90%, respectively. According to HAMD criteria, the values of PHQ-9 for mild, moderate and severe depression were 6 points, 12 points, 15 points, respectively. The consistency evaluation of PHQ-9 grade and severity degree obtained by HAMD was 0.49, and the kappa value of PHQ-9 grade and HAM D from PHQ-9 grade and HAM D was 0.89, 0.89 and 0.89 respectively, and that of PHQ-9 grade and HAM D were 0.89, 0.89 and 0.89 respectively, and that of PHQ-9 grade and HAM D were 0.89 respectively. Conclusion the health questionnaire for patients with item 9 has good validity and reliability and can be used to evaluate the degree and severity of depressive disorder in general hospitals. The demarcation value recommended by the scale maker is suitable for depressive patients in psychiatric department of general hospitals in China.
【作者单位】：北京大学第六医院;北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学);北京和睦家医院;北京大学人民医院;
【分类号】：R749.4

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