摘要
目的检验病人健康问卷抑郁量表(PHQ-9)在综合医院住院患者中应用的信度和效度,探索PHQ-9在综合医院住院患者中快速筛查抑郁的可行性。方法方便抽取四川大学华西医院569名住院患者,在规定指导语下完成PHQ-9评定,采用随机数字表法随机抽取38名患者在完成初次评定2周后进行PHQ-9重测;以简明国际神经精神访谈(MINI)作为"金标准",评估中文版PHQ-9的效标效度,共139名患者接受MINI中文版访谈。结果 PHQ-9在本研究中的Cronbach'sα系数为0.839,各条目与总评分的相关系数r=0.484~0.724(P<0.01),各条目间相关系数r=0.229~0.520(P<0.01);两周后重测系数r=0.846(P<0.01);因子分析获得3个公因子,分别为自我评价因子、情感因子和躯体化因子;最佳诊断划界分为8分,敏感度为92.6%,特异度为60.6%;PHQ-9的ROC曲线下面积为0.841(95%CI:0.777~0.905)。结论 PHQ-9应用于综合医院住院患者抑郁评估中具有良好的信效度,8分为该量表的最佳划界分。
Objective To investigate the reliability and validity of Patients＇Health Questionnaire Depression Scale-9 item （PHQ -9） in general hospital inpatients and to explore the feasibility of PHQ-9 in screening hospitalized patients in general hospital.Methods To facilitate the extraction of 569 hospitalized patients in West China Hospital of Sichuan University,PHQ-9 was completed under the specified guidance.38 patients were randomly selected by random number table and PHQ -9 retest was performed after 2 weeks of initial evaluation.Mini International Neuropsychiatric Interview（ MINI） was used as the “gold standard” to evaluate the efficacy and validity of the Chinese version of PHQ-9.A total of 139 patients were interviewed by MINI Chinese version.Results The Cronbach＇s a coefficient of PHQ -9 was 0.839 and the 2-week test-retest reliability was 0.846.The correlation coefficient of the items and total score was 0.484-0.724 （ P〈0.01 ） and between items was 0.229-0.520（ P〈0.01） .Factor analysis suggested a three-factor solution self-assessment factor,affective factor and somatic symptom factor.The best diagnostic demarcation point is 8,maximizing the Youden Index,yielded a sensitivity of 92.6% and a specificity of 60.6% .The results of ROC analysis indicated that the area under the curve （ AUC） was 0.841 （95% C7： 0.777-0.905） .Conclusion The Chinese version of PHQ-9 was shown to have good reliability and validity in general hospital inpatients.8 is the best demarcation of the scale points.
出处
《四川精神卫生》
2017年第2期149-153,共5页
Sichuan Mental Health
