Department of Psychiatry, McGill University and Jewish General Hospital, Montréal, Québec, Canada.
Rheumatology (Oxford). 2010 Apr;49(4):789-96. doi: 10.1093/rheumatology/kep443. Epub 2010 Jan 25.
The reported rates of depressive symptoms in patients with SSc are high. The Center for Epidemiologic Studies Depression Scale (CES-D) is the only measure of depressive symptoms validated for SSc patients. The objective of this study was to assess the internal consistency reliability, convergent validity and strength of association with clinical correlates of the 9-item version of the Patient Health Questionnaire depression scale (PHQ-9) compared with the CES-D in SSc.
We conducted a cross-sectional, multicentre study of 566 SSc patients who were assessed with the PHQ-9 and CES-D scales, and through clinical histories and medical examinations. Internal consistency reliability was assessed with Cronbach's alpha, convergent validity with Pearson's correlation and the relationship of socio-demographic and clinical variables with the PHQ-9 and CES-D scores using multiple linear regression.
Scale reliability was good for the PHQ-9 (alpha = 0.87) and similar to the CES-D (alpha = 0.90). Correlations of the PHQ-9 total score were -0.68 with mental health, -0.43 with physical health, 0.44 with disability, 0.40 with pain and 0.79 with fatigue, which were all in the expected direction and similar to the results with the CES-D. Regression coefficients of clinical correlates did not differ significantly between models using the PHQ-9 and CES-D.
The PHQ-9 is reliable and valid for use as a measure of depressive symptom severity in patients with SSc and performs similarly to the CES-D. However, the PHQ-9 is advantageous because it is half the length of the CES-D, easily administered and scored, and is increasingly used across many patient groups for assessment in research and clinical settings.
报道的 SSc 患者抑郁症状发生率较高。流行病学研究中心抑郁量表（CES-D）是唯一经过验证可用于 SSc 患者的抑郁症状测量工具。本研究旨在评估 9 项患者健康问卷抑郁量表（PHQ-9）与 CES-D 相比在 SSc 患者中的内部一致性信度、聚合效度以及与临床相关性的关联强度。
我们进行了一项横断面、多中心研究，纳入了 566 名 SSc 患者，他们接受了 PHQ-9 和 CES-D 量表评估，以及通过临床病史和医学检查。采用 Cronbach's alpha 评估内部一致性信度，采用 Pearson 相关系数评估聚合效度，采用多元线性回归评估社会人口统计学和临床变量与 PHQ-9 和 CES-D 评分的关系。
PHQ-9 的量表信度良好（alpha = 0.87），与 CES-D 相似（alpha = 0.90）。PHQ-9 总分与心理健康的相关性为-0.68，与身体健康的相关性为-0.43，与残疾的相关性为 0.44，与疼痛的相关性为 0.40，与疲劳的相关性为 0.79，这些相关性均在预期方向上，与 CES-D 的结果相似。使用 PHQ-9 和 CES-D 的模型中，临床相关性的回归系数没有显著差异。
PHQ-9 是一种可靠且有效的工具，可用于评估 SSc 患者的抑郁症状严重程度，其性能与 CES-D 相似。然而，PHQ-9 具有优势，因为它比 CES-D 短一半，易于管理和评分，并且在许多患者群体中越来越多地用于评估研究和临床环境。
