病人健康问卷-9在卒中抑郁患者中的信度和效度研究

Reliability and validity of PHQ-9 in patients with post-stroke depression

目的评测病人健康问卷-9(patient health questionnaire-9,PHQ-9)在我国脑卒中人群中的信度和效度。方法由经过培训的4名调查员对156例脑卒中患者分别进行Beck抑郁自评量表(Beck depression inventory,BDI)和PHQ-9、汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)和世界卫生组织复合性国际诊断访谈表3.0(World Health Organization composite international diagnostic interview,WHO-CIDI3.0)的评测,分析PHQ-9应用于脑卒中患者的信度、效度。结果克朗巴赫α系数为0.8383,提示该量表内部一致性较好;条目与总分的相关系数为0.533～0.777(P<0.05),各条目间的相关系数为0.183～0.599,提示该量表内部一致性较好;PHQ-9的效标效度为0.599(P<0.01),提示该量表效标效度良好;PHQ-9与BDI的相关系数为0.803(P<0.01),与HAMD的相关系数为0.835(P<0.01),提示该量表结构效度良好。结论 PHQ-9具有良好的信度和效度,基本符合心理测量学标准,是评价卒中后抑郁的可靠、有效工具。

Objective To investigate the reliability,validity and sensitivity of patient health questionnaire-9（PHQ-9）in patients with stroke in China.Methods One hundred and fifty-six stroke patients were assessed with Hamilton Depression Rating Scale（HAMD）.Beck Depression Inventory（BDI）,PHQ-9 and World Health Organization Composite International Diagnostic Interview（WHO-CIDI 3.0）were applied to these patients by 4 trained raters,respectively.Internal consistency reliability was tested by Cronbach＇s coefficient alpha and quantitative item analysis.Correlation analysis of BDI and PHQ-9 and that of HAMD and PHQ-9 were performed to test the structure validity.Correlation analysis of CIDI and PHQ-9 was carried out to test the criteria validity.Results The internal consistency reliability（inner-item correlation r = 0.183～0.599;item-total correlations r = 0.533～0.777 and Cranach＇s coefficient α = 0.8383）was high.The structure validity and criteria validity tested by correlation analysis showed good results.The results indicated that the scores on the PHQ-9 were significantly related to HAMD,BDI and CIDI（r = 0.835,r = 0.803,r = 0.599,respectively;P 0.01）.Conclusion PHQ-9 has good reliability and validity when applyed to Chinese stroke patients.This version of the PHQ-9 could be used to assess depression in stroke patients.