通过两个口头询问问题在基层医疗中筛查抑郁症：横断面研究。
Screening for depression in primary care with two verbally asked questions: cross sectional study.
作者信息
Arroll Bruce, Khin Natalie, Kerse Ngaire
机构信息
Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, PB 92019, Auckland, New Zealand.
出版信息
BMJ. 2003 Nov 15;327(7424):1144-6. doi: 10.1136/bmj.327.7424.1144.
OBJECTIVE
To determine the diagnostic accuracy of two verbally asked questions for screening for depression.
DESIGN
Cross sectional criterion standard validation study.
SETTING
15 general practices in New Zealand.
PARTICIPANTS
421 consecutive patients not taking psychotropic drugs.
MAIN OUTCOME MEASURES
Sensitivity, specificity, and likelihood ratios of the two questions compared with the computerised composite international diagnostic interview.
RESULTS
The two screening questions showed a sensitivity and specificity of 97% (95% confidence interval, 83% to 99%) and 67% (62% to 72%), respectively. The likelihood ratio for a positive test was 2.9 (2.5 to 3.4) and the likelihood ratio for a negative test was 0.05 (0.01 to 0.35). Overall, 37% (157/421) of the patients screened positive for depression.
CONCLUSION
Two verbally asked questions for screening for depression would detect most cases of depression in general practice. The questions have the advantage of brevity. As treatment is more likely when doctors make the diagnosis, these questions may have even greater utility.
目的
确定两个用于筛查抑郁症的口头询问问题的诊断准确性。
设计
横断面标准效度研究。
地点
新西兰的15家普通诊所。
参与者
421名连续的未服用精神药物的患者。
主要观察指标
将这两个问题与计算机化综合国际诊断访谈相比较的敏感度、特异度和似然比。
结果
这两个筛查问题的敏感度和特异度分别为97%（95%置信区间，83%至99%）和67%（62%至72%）。阳性检测的似然比为2.9（2.5至3.4），阴性检测的似然比为0.05（0.01至0.35）。总体而言，37%（157/421）的患者抑郁症筛查呈阳性。
结论
两个用于筛查抑郁症的口头询问问题能在普通诊所中检测出大多数抑郁症病例。这些问题具有简短的优势。由于医生做出诊断时更有可能进行治疗，这些问题可能具有更大的效用。
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