Becker Susan, Al Zaid Khalid, Al Faris Eiad
Department of Community and Family Health, University of South Florida, College of Public Health, Tampa 33612-3805, USA.
Int J Psychiatry Med. 2002;32(3):271-83. doi: 10.2190/XTDD-8L18-P9E0-JYRV.
Somatization, the tendency to seek treatment for medically unexplained physical symptoms, is an important issue in primary care practice. This study examines the somatoform, depression, and anxiety modules of the Patient Health Questionnaire (PHQ), a screening instrument for the identification of somatoform and other mental disorders. We also utilized the PHQ to measure the prevalence of somatization and co-morbid depression in Saudi Arabian primary care patients.
This is a cross sectional study of 431 male and female Saudi Arabian primary care patients with a two stage design for purposes of validation of the somatoform, depression and anxiety modules of the PHQ. The self administered Patient Health Questionnaire was given to 431 primary care patients and, of this group, the first, consecutive 173 patients (40 percent) were interviewed by mental health professionals using the Structured Clinical Interview (SCID-R) as the criterion standard for validation of the PHQ in the Saudi population. The PHQ was then used to measure the prevalence of somatization and depression in the remaining 258 patients.
The somatoform and depression modules of the PHQ were found to be valid in a Saudi population using the criterion standard of SCID based psychiatric interviews. Agreement between the PHQ and psychiatric interviews was (kappa = .65) for both somatoform disorders and depression but the anxiety module was weak in terms of sensitivity (.37) and agreement with the criterion standard (k = .37). Clinically significant rates of somatization (19.3 percent) and depression (20 percent) were identified in this population.
The prevalence of somatization and co-morbid depression in a primary care population in Saudi Arabia is similar to published rates in the U.S. and worldwide. It is possible to screen primary care patients for mental disorders in international settings and the PHQ is valid instrument for that purpose.
躯体化，即因医学上无法解释的身体症状而寻求治疗的倾向，是初级保健实践中的一个重要问题。本研究考察了患者健康问卷（PHQ）的躯体形式障碍、抑郁和焦虑模块，这是一种用于识别躯体形式障碍和其他精神障碍的筛查工具。我们还利用PHQ来测量沙特阿拉伯初级保健患者中躯体化和共病抑郁的患病率。
这是一项对431名沙特阿拉伯初级保健患者的横断面研究，采用两阶段设计以验证PHQ的躯体形式障碍、抑郁和焦虑模块。向431名初级保健患者发放了自填式患者健康问卷，在这组患者中，前173名连续患者（40%）由心理健康专业人员使用结构化临床访谈（SCID-R）进行访谈，SCID-R作为沙特人群中验证PHQ的标准。然后用PHQ测量其余258名患者中躯体化和抑郁的患病率。
以基于SCID的精神病学访谈为标准，发现PHQ的躯体形式障碍和抑郁模块在沙特人群中有效。PHQ与精神病学访谈在躯体形式障碍和抑郁方面的一致性（kappa = 0.65），但焦虑模块在敏感性（0.37）和与标准的一致性（kappa = 0.37）方面较弱。在该人群中确定了具有临床意义的躯体化率（19.3%）和抑郁率（20%）。
沙特阿拉伯初级保健人群中躯体化和共病抑郁的患病率与美国及全球公布的患病率相似。在国际环境中对初级保健患者进行精神障碍筛查是可行的，PHQ是用于此目的的有效工具。
