MindSpot Clinic, Macquarie University, Sydney, Australia; eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
MindSpot Clinic, Macquarie University, Sydney, Australia; eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
Gen Hosp Psychiatry. 2019 Jan-Feb;56:13-18. doi: 10.1016/j.genhosppsych.2018.11.003. Epub 2018 Nov 22.
The nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), and ten-item Kessler Psychological Distress Scale (K-10) are valid and reliable measures of depression, anxiety and general distress. However, the time required in their administration may limit their use in routine care. This study examines the utility of shorter versions (PHQ-2, GAD-2, and K-6) as screening instruments and measures of treatment response.
Data from research trial participants (n = 993) receiving internet-delivered cognitive behaviour therapy (iCBT) were analysed to establish discriminant validity of the short versions. Mini International Neuropsychiatric Interview (MINI) diagnoses were used as comparators. Criterion group validity, test-retest reliability, internal consistency, and responsiveness to treatment changes were examined. Analyses were replicated using data from patients receiving iCBT in routine care (n = 1389).
Discriminant validity was excellent for the PHQ-2, and acceptable for the GAD-2 and K-6. Acceptable sensitivity and specificity were identified at a threshold of ≥3 for the PHQ-2 and GAD-2, and ≥14 for the K-6. The short versions were sensitive to treatment change.
The PHQ-2, GAD-2 and K-6 are useful screeners and efficient measures of treatment progress and outcomes in routine clinical care.
九项患者健康问卷（PHQ-9）、七项广泛性焦虑症量表（GAD-7）和十项凯斯勒心理困扰量表（K-10）是评估抑郁、焦虑和一般困扰的有效且可靠的工具。然而，它们的管理所需时间可能会限制其在常规护理中的使用。本研究探讨了较短版本（PHQ-2、GAD-2 和 K-6）作为筛查工具和治疗反应衡量标准的效用。
对接受互联网提供的认知行为疗法（iCBT）的研究试验参与者（n=993）的数据进行分析，以确定短版本的判别有效性。使用迷你国际神经精神访谈（MINI）诊断作为对照。对临界组有效性、重测信度、内部一致性和对治疗变化的反应进行了检验。使用常规护理中接受 iCBT 的患者的数据（n=1389）进行了复制分析。
PHQ-2 的判别有效性非常好，GAD-2 和 K-6 的判别有效性可接受。PHQ-2 和 GAD-2 的阈值≥3，K-6 的阈值≥14 时，可识别出可接受的敏感性和特异性。短版本对治疗变化敏感。
PHQ-2、GAD-2 和 K-6 是常规临床护理中有用的筛查工具和衡量治疗进展和结果的有效指标。
