Ozdemir Hatice, Rezaki Murat
Hacettepe U Oğrenci Sağlik Merkezi, Ankara, Turkey.
Turk Psikiyatri Derg. 2007 Spring;18(1):13-21.
The aim of this study was to assess the validity and the possible cut-off points of the General Health Questionnaire-12 (GHQ-12) in detecting depression in university students.
The study included 170 students (115 females and 55 males) that consecutively applied to a university student health center psychiatric clinic and who were asked to complete a sociodemographic data form and the GHQ-12 before their visit with the psychiatrist. DSM-IV psychiatric diagnoses were established using the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).
Depression was the most prevalent DSM-IV diagnosis (49%) and 35% of the students did not have any psychiatric diagnosis. Mean GHQ-12 score was 7.5+/-3.7 (8.0+/-3.6 for females and 6.4+/-3.7 for males, p<0.05). Sensitivity and specificity for depressive disorder were 83% and 65% (for the cut-off point 7/8), 75% and 77% (for the cut-off point 8/9), and 62% and 88% (for the cut-off point 9/10), respectively. The internal consistency (Cronbach's alpha 0.88) was good. Kappa coefficient for agreement between DSM diagnosis for depression and GHQ (cut-off 8/9) was 0.52. Item 9, which inquired about pleasure, produced the highest odds ratio for the diagnosis of depression (OR(CI)=11.84 (4.66-30.08)).
The results of this study revealed that GHQ-12 is a useful screening instrument for the detection of depression with a high cut-off point (8/9). The students' tendency to report more psychological symptoms and the administration of the instrument in a student psychiatric clinic could be the reasons for the high GHQ-12 cut-off points. We propose the use of high cut-off points for students who applied to a psychiatric clinic for more accurate detection of depression.
本研究旨在评估一般健康问卷12项(GHQ - 12)在检测大学生抑郁症方面的有效性及可能的临界值。
该研究纳入了170名学生(115名女性和55名男性),他们连续前往某大学生健康中心精神科诊所就诊,并被要求在与精神科医生面谈前填写一份社会人口学数据表格及GHQ - 12。使用《精神疾病诊断与统计手册》第四版轴I障碍结构化临床访谈(SCID - I)确立DSM - IV精神疾病诊断。
抑郁症是最常见的DSM - IV诊断(49%),35%的学生没有任何精神疾病诊断。GHQ - 12平均得分是7.5±3.7(女性为8.0±3.6,男性为6.4±3.7,p<0.05)。抑郁症的敏感性和特异性分别为:临界值7/8时为83%和65%,临界值8/9时为75%和77%,临界值9/10时为62%和88%。内部一致性(Cronbach's α 0.88)良好。DSM抑郁症诊断与GHQ(临界值8/9)之间的一致性kappa系数为0.52。询问愉悦感的第9项对抑郁症诊断产生的比值比最高(OR(CI)=11.84 (4.66 - 30.08))。
本研究结果表明,GHQ - 12是一种有用的抑郁症筛查工具,采用高临界值(8/9)。学生报告更多心理症状的倾向以及在学生精神科诊所使用该工具可能是GHQ - 12临界值较高的原因。我们建议对前往精神科诊所的学生采用高临界值以更准确地检测抑郁症。