Greater Green Triangle University Department of Rural Health (GGT UDRH), Flinders University & Deakin University, Australia.
Br J Gen Pract. 2010 Jun;60(575):e239-45. doi: 10.3399/bjgp10X502128.
Clinical guidelines advise screening for depression in patients with diabetes. The Patient Health Questionnaire (PHQ-9) and the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) are commonly used in primary care.
To compare the efficacy of HADS-D and PHQ-9 in identifying moderate to severe depression among primary care patients with type 2 diabetes.
Self-report postal survey, clinical records assessed by GPs.
Seven metropolitan and rural general practices in Victoria, Australia.
Postal questionnaires were sent to all patients with diabetes on the registers of seven practices in Victoria. A total of 561 completed postal questionnaires were returned, giving a response rate 47%. Surveys included demographic information, and history of diabetes and depression. Participants completed both the PHQ-9 and HADS-D. Clinical data from patient records included glycosylated hemoglobin (HbA1c) levels and medications.
The proportion of the total sample completing HADS-D was 96.8% compared with 82.4% for PHQ-9. Level of education was unrelated to responses on the HADS-D but was related to completion of the PHQ-9. Using complete data (n = 456) from both measures, 40 responders showed HADS-D scores in the moderate to severe range, compared with 103 cases identified by PHQ-9. Only 35 cases were classified in the moderate to severe category by both the PHQ-9 and HADS-D. Items with the highest proportions of positive responses on the PHQ-9 were related to tiredness and sleeping problems and, on the HADS-D, feeling slowed down.
It may be that the items contributing to the higher prevalence of moderate to severe depression using the PHQ-9 are due to diabetes-related symptoms or sleep disorders.
临床指南建议对糖尿病患者进行抑郁症筛查。在初级保健中，通常使用患者健康问卷（PHQ-9）和医院焦虑和抑郁量表（HADS-D）的抑郁分量表。
比较 HADS-D 和 PHQ-9 在识别 2 型糖尿病初级保健患者中中重度抑郁症的效果。
自我报告的邮政调查，由全科医生评估的临床记录。
澳大利亚维多利亚州的七个大都市和农村全科诊所。
向维多利亚州七家诊所登记的所有糖尿病患者邮寄了问卷。共收到 561 份完整的邮寄问卷，应答率为 47%。调查包括人口统计学信息和糖尿病和抑郁症病史。参与者完成了 PHQ-9 和 HADS-D。来自患者记录的临床数据包括糖化血红蛋白（HbA1c）水平和药物。
完成 HADS-D 的总样本比例为 96.8%，而完成 PHQ-9 的比例为 82.4%。教育水平与 HADS-D 的反应无关，但与 PHQ-9 的完成有关。使用来自两种测量方法的完整数据（n=456），40 名应答者的 HADS-D 评分显示处于中度至重度范围，而 PHQ-9 识别的病例为 103 例。只有 35 例病例同时被 PHQ-9 和 HADS-D 分类为中度至重度。PHQ-9 阳性反应比例最高的项目与疲劳和睡眠问题有关，而 HADS-D 则与感觉行动迟缓有关。
使用 PHQ-9 检测到的中重度抑郁症患病率较高，可能是由于糖尿病相关症状或睡眠障碍所致。
