患者健康问卷-15与精神疾病诊断与统计手册躯体诊断之间的关系。
The relation between the patient health questionnaire-15 and DSM somatic diagnoses.
作者信息
Liao Shih-Cheng, Huang Wei-Lieh, Ma Huei-Mei, Lee Min-Tzu, Chen Tzu-Ting, Chen I-Ming, Gau Susan Shur-Fen
机构信息
Department of Psychiatry, National Taiwan University Hospital, No.7, Zhongshan S. Rd, Zhongzheng Dist, Taipei City, 100, Taiwan (Republic of China).
Department of Psychiatry, College of Medicine, National Taiwan University, No.1, Sec. 1, Ren'ai Rd, Zhongzheng Dist, Taipei City, 100, Taiwan (Republic of China).
出版信息
BMC Psychiatry. 2016 Oct 18;16(1):351. doi: 10.1186/s12888-016-1068-2.
BACKGROUND
Our purpose was to examine the reliability and validity of the Chinese version of the Patient Health Questionnaire-15 (PHQ-15) in Taiwan, and to explore its relation to somatoform disorders (DSM-IV) and to somatic symptom and related disorders (DSM-5).
METHODS
We recruited 471 individuals, 151 with somatoform disorders and 200 with somatic symptom and related disorders. Subjects completed the Chinese version of the PHQ-15, Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and received a DSM-IV- and DSM-5-based diagnostic interview. We performed exploratory factor analysis and assessed test-retest reliability, internal consistency, and correlation with BDI-II/BAI to confirm reliability and validity, and carried out ROC curve analysis to determine suitability for evaluation or screening purposes. PHQ-15 scores were compared between patients with various DSM-IV psychiatric diagnoses (such as DSM-IV somatoform disorders, panic disorder, other anxiety/depressive disorders) or no DSM-IV diagnosis and patients with DSM-5 somatic symptom and related disorders or no DSM-5 diagnosis.
RESULTS
The Chinese version identified cardiopulmonary, pain-fatigue, and gastrointestinal as major factors and had good reliability (0.803-0.930), internal consistency (0.637-0.861), and correlation coefficients with BDI-II/BAI (0.407-0.619, 0.536-0.721, respectively). The PHQ-15 scores were similar in patients with somatoform disorders and patients with panic disorder; higher in patients with somatoform disorders and panic disorder than in patients with other anxiety/depressive disorders; and significantly higher in patients with somatic symptom and related disorders than in patients without this diagnosis. The AUC of the PHQ-15 was 0.678 (cutoff 6/7) for screening somatoform disorders (DSM-IV) and 0.725 (cutoff 4/5) for screening somatic symptom and related disorders (DSM-5).
CONCLUSIONS
The Chinese version of the PHQ-15 is suitable for evaluating somatic symptom and related disorders. The preponderance of somatic symptom disorder in our sample, lack of evaluation of functional disorders, and recruitment solely from psychiatric clinics are possible limitations.
背景
我们的目的是检验中文版患者健康问卷-15（PHQ-15）在台湾地区的信度和效度，并探讨其与躯体形式障碍（DSM-IV）以及躯体症状及相关障碍（DSM-5）之间的关系。
方法
我们招募了471名个体，其中151名患有躯体形式障碍，200名患有躯体症状及相关障碍。受试者完成了中文版PHQ-15、贝克抑郁量表第二版（BDI-II）、贝克焦虑量表（BAI），并接受了基于DSM-IV和DSM-5的诊断访谈。我们进行了探索性因子分析，并评估了重测信度、内部一致性以及与BDI-II/BAI的相关性以确认信度和效度，还进行了ROC曲线分析以确定其是否适合用于评估或筛查。比较了患有各种DSM-IV精神疾病诊断（如DSM-IV躯体形式障碍、惊恐障碍、其他焦虑/抑郁障碍）或无DSM-IV诊断的患者与患有DSM-5躯体症状及相关障碍或无DSM-5诊断的患者的PHQ-15得分。
结果
中文版确定心肺、疼痛-疲劳和胃肠道为主要因子，具有良好的信度（0.803 - 0.930）、内部一致性（0.637 - 0.861）以及与BDI-II/BAI的相关系数（分别为0.407 - 0.619、0.536 - 0.721）。躯体形式障碍患者和惊恐障碍患者的PHQ-15得分相似；躯体形式障碍和惊恐障碍患者的得分高于其他焦虑/抑郁障碍患者；躯体症状及相关障碍患者的得分显著高于无此诊断的患者。PHQ-15筛查躯体形式障碍（DSM-IV）的曲线下面积（AUC）为0.678（临界值6/7），筛查躯体症状及相关障碍（DSM-5）的AUC为0.725（临界值4/5）。
结论
中文版PHQ-15适用于评估躯体症状及相关障碍。本样本中躯体症状障碍占优势、未对功能障碍进行评估以及仅从精神科诊所招募受试者可能是局限性所在。
Zotero 插件