Brooker Centre, Runcorn, UK.
Int J Psychiatry Clin Pract. 2009;13(3):188-91. doi: 10.1080/13651500802684500.
Background. Both dementia and depression may produce complaints of memory impairment. Differential diagnosis may be difficult, but has practical implications regarding choice of appropriate treatment. Aim. To assess the clinical utility of the Patient Health Questionnaire-9 (PHQ-9), a validated instrument for measurement of depression severity, in differentiating patients with and without dementia, referred with complaints of memory impairment to dedicated memory clinics. Methods. Pragmatic prospective study of consecutive referrals (n=113) to two dementia clinics, diagnosed using standard clinical diagnostic criteria for dementia (DSM-IV) and also administered the PHQ-9. Results. PHQ-9 proved acceptable to patients, and was quick and easy to use. Using traditional parameters of diagnostic utility (sensitivity, specificity, positive predictive value, likelihood ratios), PHQ-9 performance was modest for the diagnosis of dementia. However, pragmatically PHQ-9 scores proved helpful in deciding which patients, both with and without dementia, required a trial of antidepressant medication. Conclusions. PHQ-9 proved useful as a brief screen for depression in patients attending dementia clinics with a complaint of memory impairment.
痴呆和抑郁都可能导致记忆障碍的主诉。鉴别诊断可能很困难，但对于选择适当的治疗方法具有实际意义。目的：评估患者健康问卷-9（PHQ-9）的临床实用性，该问卷是一种经过验证的用于测量抑郁严重程度的工具，可用于区分因记忆障碍就诊于专门记忆诊所的痴呆和非痴呆患者。方法：对 113 例连续转诊至 2 家痴呆诊所的患者进行实用前瞻性研究，采用DSM-IV 标准临床诊断标准诊断痴呆，并同时使用 PHQ-9 进行评估。结果：PHQ-9 易于患者接受，且使用方便快捷。使用传统的诊断效用参数（敏感性、特异性、阳性预测值、似然比），PHQ-9 对痴呆的诊断效能中等。然而，PHQ-9 评分在决定哪些有或无痴呆的患者需要进行抗抑郁药物试验方面具有实际帮助。结论：PHQ-9 作为一种简短的筛查工具，可用于评估因记忆障碍就诊于痴呆诊所的患者的抑郁情况。
