Department of Psychology, WSB University in Toruń, Toruń, Poland.
Department of Psychology, Faculty of Education, Psychology Research Unit for Public Health, University of Lower Silesia, Wroclaw, Poland.
PLoS One. 2020 Oct 23;15(10):e0240209. doi: 10.1371/journal.pone.0240209. eCollection 2020.
This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and 'MDD and/or dysthymia' in people with and without type 2 diabetes.
Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden's index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice.
The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden's index and ≥ 5 by the two-stage method for screening for MDD and 'MDD and/or dysthymia' in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and 'MDD and/or dysthymia' among people without diabetes (Youden's index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for 'MDD and/or dysthymia' in people without diabetes.
A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.
本研究评估了 PHQ-9 波兰语版在检测 2 型糖尿病患者和非 2 型糖尿病患者中是否存在重度抑郁症（MDD）和“MDD 和/或心境恶劣”的心理测量学特征。
参与者随机选自糖尿病门诊（N=216）和内科中心和精神病医院的患者（N=99）。参与者完成 PHQ-9 量表。使用汉密尔顿抑郁评定量表和迷你国际神经精神访谈来确定是否存在精神症状。根据两种方法，探讨 PHQ-9 在 2 型糖尿病患者和非 2 型糖尿病患者中的最佳截断值：1）约登指数，用于识别对科学研究有用的截断点；2） 用于筛查抑郁障碍的两步筛查方法，为临床实践提供指导。
PHQ-9 波兰语版是 2 型糖尿病和非 2 型糖尿病患者抑郁的可靠有效筛查工具。约登指数表明，最佳截断值为≥7，两步法筛查 2 型糖尿病患者的 MDD 和“MDD 和/或心境恶劣”的最佳截断值为≥5。无糖尿病患者的最佳截断值为≥11，用于筛查 MDD 和“MDD 和/或心境恶劣”（约登指数）。两步法建议无糖尿病患者的 MDD 筛查最佳截断值为≥10，“MDD 和/或心境恶劣”筛查最佳截断值为≥9。
与一般人群相比，建议将 PHQ-9 的较低截断值用于 2 型糖尿病患者。
