Indiana University, School of Medicine, Indianapolis, IN, United States.
Indiana University, School of Medicine, Indianapolis, IN, United States; Regenstrief Institute Inc, Indianapolis, IN, United States.
Gen Hosp Psychiatry. 2021 Jan-Feb;68:74-82. doi: 10.1016/j.genhosppsych.2020.12.007. Epub 2020 Dec 21.
Perinatal depression (PND) is a prevalent and disabling problem both during pregnancy and the postpartum period. The legacy screening measure has been the Edinburgh Postnatal Depression Scale (EPDS). This systematic review examines the validity of the PHQ-9 as a screener for PND.
The following databases were searched from January 2001 (when the PHQ-9 was first published) through June 2020: MEDLINE, Embase, and PsychInfo. Studies that compared the PHQ-9 to a criterion standard psychiatric interview were used to determine the operating characteristics of sensitivity, specificity and area under the curve (AUC). Studies comparing the PHQ-9 to the EPDS and other depression scales evaluated convergent validity.
A total of 35 articles were eligible for criterion (n = 10) or convergent (n = 25) validity. Meta-analysis of the 7 criterion validity studies using the standard PHQ-9 cut point ≥10 showed a pooled sensitivity, specificity and AUC of 0.84, 0.81 and 0.89, respectively. Operating characteristics of the PHQ-9 and EPDS were nearly identical in head-to-head comparison studies. The median correlation between the PHQ-9 and EPDS was 0.59, and categorical agreement was moderate.
The PHQ-9 appears to be a viable option for perinatal depression screening with operating characteristics similar to the legacy EPDS.
围产期抑郁症（PND）在妊娠和产后期间都是一种普遍且使人丧失能力的问题。传统的筛查方法是爱丁堡产后抑郁量表（EPDS）。本系统评价研究了 PHQ-9 作为 PND 筛查工具的有效性。
从 2001 年 1 月（PHQ-9 首次发表）到 2020 年 6 月，检索了以下数据库：MEDLINE、Embase 和 PsychInfo。使用比较 PHQ-9 与标准精神科访谈的研究来确定灵敏度、特异性和曲线下面积（AUC）的操作特征。比较 PHQ-9 与 EPDS 和其他抑郁量表的研究评估了收敛效度。
共有 35 篇文章符合标准（n=10）或收敛（n=25）有效性标准。使用标准 PHQ-9 切点≥10 对 7 项标准有效性研究进行荟萃分析，灵敏度、特异性和 AUC 的汇总值分别为 0.84、0.81 和 0.89。PHQ-9 和 EPDS 的操作特征在头对头比较研究中几乎相同。PHQ-9 和 EPDS 之间的中位数相关性为 0.59，类别一致性为中等。
PHQ-9 似乎是一种可行的围产期抑郁筛查选择，其操作特征与传统的 EPDS 相似。
