摘要
目的:初步探讨中文版超简抑郁焦虑筛查量表[4条目患者健康问卷(patient health questionnaire 4,PHQ-4)]在社区门诊患者中的信度与效度。方法:在上海2家社区卫生服务中心门诊随机抽取313例患者,由1名精神科主治医师和经过培训的2名全科医师,使用规定指导语帮助患者完成PHQ-4自评,并进行汉密尔顿抑郁量表(Hamilton depression scale,HAMD)和汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评定,最后采用国际神经精神科简式访谈问卷进行访谈。初次评定后7~14 d内,随机抽取其中50例患者进行PHQ-4重测。对PHQ-4的内在一致性信度、重测信度、效标效度和结构效度等进行计算分析;并进行受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析确定最佳分界值,计算灵敏度、特异度等。结果:PHQ-4的内在一致性信度克龙巴赫α系数(Cronbach’α系数)为0.833,折半信度的Spearman-Brown系数为0.835。重测信度计算组内相关系数(intraclass correlation coefficient,ICC)为0.969。PHQ-4总分与HAMD、HAMA总分的相关系数分别为0.391和0.407,差异均具有统计学意义(P<0.01)。ROC分析得出曲线下面积(area under curve,AUC)为0.919,最佳分界值为3分。PHQ-4的灵敏度和特异度分别为87.1%和82.6%。结论:中文版PHQ-4在社区门诊患者中具有较好的信度和效度,适合抑郁、焦虑的筛查。
Objective To preliminary evaluate the reliability and validity of the ultra-brief screening scale for depression and anxiety[patient health questionnaire 4(PHQ-4)]in outpatients clinics of community healthcare centers.Methods Totally 313 patients were randomly selected from two community healthcare centers in Shanghai.The patients were asked to complete the PHQ-4 following the prescribed instruction with assistance of a psychiatrist and two physicians,and then were evaluated according Hamilton depression scale(HAMD)and the Hamilton anxiety scale(HAMA)followed by a mini international neuropsychiatric interview(MINI).Out of subjects screened,50 patients were randomly selected to retest the PHQ-4.The reliability coefficients,retest reliability and criterion validity sensitivity and specificity were calculated.The receiver operating characteristic(ROC)analysis was performed to determine the best cut-off value,and the sensitivity and specificity accordingly.Results The Cronbach’αcoefficient of PHQ-4 was 0.833,the Spearman-Brown coefficient of the split-half reliability was 0.835.For the test-retest reliability,the intraclass correlation coefficient(ICC)was 0.969.The correlation coefficients of generalized anxiety disorder 7(GAD-7)with HAMD and HAMA were 0.391 and 0.407 respectively,both statistically significant(P<0.01).ROC analysis showed that the area under curve(AUC)was 0.919,and the best cut-off value was 3,the sensitivity and specificity of PHQ-4 were 87.1%and 82.6%respectively.Conclusions The Chinese version of the PHQ-4 maintains high reliability and validity in outpatient clinics of community healthcare centers,and is suitable for the screening of depression and anxiety.
作者
钱洁
姜敏敏
陈晨
陈玉娇
于德华
李春波
QIAN Jie;JIANG Minmin;CHEN Chen;CHEN Yujiao;YU Dehua;LI Chunbo(Department of Clinical Psychology,Shanghai Yangpu District Central Hospital,Tongji University School of Medicine,Shanghai 200090,China;Department of General Practice,Shanghai Yangpu District Central Hospital,Tongji University School of Medicine,Shanghai 200090,China;Shanghai Yangpu District Changhai Community Health Service Center,Shanghai 200433,China;Shanghai Jing'an District Jiangning Road Community Health Service Center,Shanghai 200040,China;Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Institute of Psychology and Behavioral Science,Shanghai Jiao Tong University,Shanghai 200030,China)
出处
《内科理论与实践》
2021年第2期116-120,共5页
Journal of Internal Medicine Concepts & Practice
基金
国家重点研发计划(项目编号:2018YFC2001605)
上海市领军人才计划(项目编号:YDH-20170627)
上海市卫生健康委员会科研课题计划(项目编号:20194Y0027)
上海市科学技术委员会科研计划项目(项目编号:19MC1911100)。
关键词
超简抑郁焦虑筛查量表
患者健康问卷
信度
效度
社区门诊
The ultra-brief screening scale for depression and anxiety
Patient health questionnaire 4
Reliability
Validity
Community healthcare center outpatients
