一项针对初级保健老年人群中 PHQ-9 诊断准确性的研究。
A study of the diagnostic accuracy of the PHQ-9 in primary care elderly.
机构信息
Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, WA, USA.
出版信息
BMC Fam Pract. 2010 Sep 1;11:63. doi: 10.1186/1471-2296-11-63.
BACKGROUND
The diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depression in elderly persons in primary care settings in the United States has not been previously addressed. Thus, the purpose of this study was to evaluate the test performance of the PHQ-9 for detecting major and minor depression in elderly patients in primary care.
METHODS
A prospective study of diagnostic accuracy was conducted in two primary care, university-based clinics in the Pacific Northwest of the United States. Seventy-one patients aged 65 years or older participated; all completed the PHQ-9 and the 15-item Geriatric Depression Scale (GDS) and underwent the Structured Clinical Interview for Depression (SCID). Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, and likelihood ratios (LRs) were calculated for the PHQ-9, the PHQ-2, and the 15-item GDS for major depression alone and the combination of major plus minor depression.
RESULTS
Two thirds of participants were female, with a mean age of 78 and two chronic health conditions. Twelve percent met SCID criteria for major depression and 13% minor depression. The PHQ-9 had an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.74-1.00) for major depression, while the PHQ-2 and the 15-item GDS each had an AUC of 0.81 (95% CI for PHQ-2, 0.64-0.98, and for 15-item GDS, 0.70-0.91; P = 0.551). For major and minor depression combined, the AUC for the PHQ-9 was 0.85 (95% CI, 0.73-0.96), for the PHQ-2, 0.80 (95% CI, 0.68-0.93), and for the 15-item GDS, 0.71 (95% CI, 0.55-0.87; P = 0.187).
CONCLUSIONS
Based on AUC values, the PHQ-9 performs comparably to the PHQ-2 and the 15-item GDS in identifying depression among primary care elderly.
背景
PHQ-9 用于评估美国初级保健环境中老年人的抑郁状况的诊断准确性尚未得到研究。因此，本研究旨在评估 PHQ-9 用于诊断老年患者中主要和次要抑郁的测试性能。
方法
在太平洋西北地区的两个基于大学的初级保健诊所进行了前瞻性诊断准确性研究。71 名年龄在 65 岁或以上的患者参加了该研究；所有患者均完成了 PHQ-9 和 15 项老年抑郁量表（GDS），并接受了抑郁结构临床访谈（SCID）。为 PHQ-9、PHQ-2 和 15 项 GDS 单独评估主要抑郁和主要加次要抑郁的组合计算了敏感性、特异性、接收者操作特征（ROC）曲线下面积和似然比（LRs）。
结果
参与者中有三分之二为女性，平均年龄为 78 岁，有两种慢性健康状况。12%的患者符合 SCID 主要抑郁标准，13%的患者符合次要抑郁标准。PHQ-9 对主要抑郁的曲线下面积（AUC）为 0.87（95%置信区间[CI]，0.74-1.00），而 PHQ-2 和 15 项 GDS 的 AUC 分别为 0.81（PHQ-2 的 95% CI，0.64-0.98，15 项 GDS 的 95% CI，0.70-0.91；P = 0.551）。对于主要和次要抑郁的组合，PHQ-9 的 AUC 为 0.85（95% CI，0.73-0.96），PHQ-2 的 AUC 为 0.80（95% CI，0.68-0.93），15 项 GDS 的 AUC 为 0.71（95% CI，0.55-0.87；P = 0.187）。
结论
根据 AUC 值，PHQ-9 在识别初级保健老年患者中的抑郁方面与 PHQ-2 和 15 项 GDS 表现相当。
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