Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan;
Pediatrics. 2014 Feb;133(2):e402-9. doi: 10.1542/peds.2013-0204. Epub 2014 Jan 20.
The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire-9 item (PHQ-9) and its 2 subscales (1 item and 2 items) for the screening of major depressive disorder (MDD) among adolescents in Taiwan.
A total of 2257 adolescents were recruited from high schools in Taipei. The participants completed assessments including demographic information, the Chinese version of the PHQ-9, and the Rosenberg Self-Esteem Scale, and data on the number of physical illnesses and mental health service utilizations were recorded. Among them, 430 were retested using the PHQ-9 within 2 weeks. Child psychiatrists interviewed a subsample of the adolescents (n = 165) using the Kiddie-Schedule for Affective Disorder and Schizophrenia Epidemiological Version as the criterion standard.
The PHQ-9 had good internal consistency (α = 0.84) and acceptable test-retest reliability (0.80). The participants with higher PHQ-9 scores were more likely to have MDD. Principal component factor analysis of the PHQ-9 yielded a 1-factor structure, which accounted for 45.3% of the variance. A PHQ-9 score ≥15 had a sensitivity of 0.72 and a specificity of 0.95 for recognizing MDD. The area under the receiver operating characteristic curve was 0.90. The screening accuracy of the 2 subscales was also satisfactory, with a Patient Health Questionnaire-2 item cutoff of ≥3 being 94.4% sensitive and 82.5% specific and a Patient Health Questionnaire-1 item cutoff of ≥2 being 61.1% sensitive and 87.7% specific.
The PHQ-9 and its 2 subscales appear to be reliable and valid for detecting MDD among ethnic Chinese adolescents in Taiwan.
本研究旨在确定中文版患者健康问卷-9 项（PHQ-9）及其 2 个分量表（1 项和 2 项）用于筛查台湾青少年重度抑郁症（MDD）的可靠性和有效性。
共招募 2257 名来自台北高中的青少年。参与者完成了人口统计学信息、中文版 PHQ-9 和罗森伯格自尊量表的评估，记录了身体疾病的数量和精神卫生服务的利用情况。其中，430 人在 2 周内使用 PHQ-9 进行了重新测试。儿童精神科医生使用儿童心境障碍和精神分裂症流行病学修订版（Kiddie-Schedule for Affective Disorder and Schizophrenia Epidemiological Version）对青少年的亚样本（n=165）进行了访谈，作为标准。
PHQ-9 具有良好的内部一致性（α=0.84）和可接受的重测信度（0.80）。PHQ-9 得分较高的参与者更有可能患有 MDD。PHQ-9 的主成分因子分析得出了 1 个因子结构，占 45.3%的方差。PHQ-9 得分≥15 对识别 MDD 的灵敏度为 0.72，特异性为 0.95。受试者工作特征曲线下面积为 0.90。2 个分量表的筛查准确性也令人满意，PHQ-2 项得分≥3 的灵敏度为 94.4%，特异性为 82.5%，PHQ-1 项得分≥2 的灵敏度为 61.1%，特异性为 87.7%。
PHQ-9 及其 2 个分量表似乎可用于检测台湾华裔青少年的 MDD，具有可靠性和有效性。
