病人健康问卷抑郁量表(PHQ-9)在青少年中应用的信效度检验

Reliability and validity of the patient health questionnaire-9 in Chinese adolescents

目的 检验病人健康问卷抑郁量表（PHQ-9）在青少年中应用的信度和效度.方法 方便抽取河南省济源、新乡两地共3所中学,再以班级为单位采用整群抽样方法抽取初中一年级到高中三年级的14～ 18岁在校中学生471名进行PHQ-9测查,同时进行美国《精神障碍诊断与统计手册（第4版）》（DSM-Ⅳ）临床定式访谈（SCID）抑郁量表评定和贝克抑郁量表（BDI）评定.在样本中选取88人4周后完成PHQ-9重测.结果 PHQ-9总分的Cronbach α系数为0.85,条目间相关系数为0.289～0.560,各条目与PHQ-9总分相关系数为0.616 ～0.730,4周后重测信度为0.88.PHQ-9总分与BDI总分Pearson相关系数为0.77,主成分因子分析显示因子（躯体化-情感因子）突出.PHQ-9评估抑郁情绪的最佳划界分为10分,灵敏度为93.33％,特异度为96.83％;ROC曲线下面积（AUC）为0.984（95％CI 0.969～0.993）.结论 PHQ-9应用于青少年抑郁情绪评估中具有良好的信度与效度,10分为该量表的最佳诊断划界分.

Objective To test the reliability and validity of the Patient Health Questionnaire - 9 （ PHQ - 9） in adolescents. Methods A total of 471 adolescents with age 14 -18 years completed the PHQ -9 and the Beck Depression Inventory （BDI） ques- tionnaire. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders （SCID） was used to diagnose de- pression. A total of 88 participants completed PHQ - 9 test - retest after 4 week. Results The factor analysis of PHQ - 9 identified a unifactorial structure （ somatization - emotional factor）. Cronbach ct coefficient of PHQ - 9 was 0.85. The mean inter - item correla- tion coefficients ranged from 0. 289 ～ 0. 560. The correlation coefficients of the nine items with the total scale ranged from 0. 616 ～ 0.730. The test - retest reliability value of PHQ - 9 was 0.88. The scores of PHQ - 9was significantly associated with that of BDI（ r = 0.77）. PHQ -9 had an optimal cutoff score of 10, which indicated a sensitivity of 93.33% and a specificity of 96.83%, with an area under the curve of 0. 984 （95% CI 0. 969 ～ 0. 993 ）. Conclusion The PHQ - 9 has satisfactory reliability and validity and can be used in adolescents. For screening purposes, cutoff score of 10 was be recommended.