Department of Psychiatry, Massachusetts General Hospital, United States; Harvard Medical School, United States.
Department of Psychiatry, Massachusetts General Hospital, United States; Harvard Medical School, United States; Department of Neuropsychiatry, Keio University School of Medicine, United States.
J Affect Disord. 2021 Mar 1;282:1021-1029. doi: 10.1016/j.jad.2021.01.005. Epub 2021 Jan 7.
It is critical to promptly identify and monitor mood and anxiety symptoms in young people with SUD. The primary aim of this study was to conduct a psychometric validation of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) for depression and anxiety screening in young people seeking outpatient treatment for SUD. Our secondary aim was to compare the performance of the PHQ-9 and GAD-7 to their briefer two-item versions (PHQ-2 and GAD-2) in terms of detecting probable mood and anxiety disorders.
Data were extracted from the electronic health records of patients (ages 14 to 26) who received a diagnostic evaluation following clinical implementation of the PHQ-9 and GAD-7 at a hospital-based outpatient SUD treatment program (N=121, average age 19.1 ± 3.1 years).
The PHQ-9 and GAD-7 showed excellent internal consistency. A PHQ-9 cut score of 7 or 8 (PHQ-2 cut score: 2) and GAD-7 cut score of 6 (GAD-2 cut score: 2) had the best balance of sensitivity, specificity, and positive and negative predictive power in these data. These measures also showed good convergent and acceptable discriminant validity.
The sample was predominantly White and non-Hispanic, and a validated (semi-)structured diagnostic interview was not used to establish mood and anxiety disorder diagnoses.
Results suggest the PHQ-9 and GAD-7 are reliable and potentially clinically useful screening tools for depression and anxiety in young people with SUD, and that the two-item versions may have similar clinical utility as the full measures.
及时识别和监测患有物质使用障碍的年轻人的情绪和焦虑症状至关重要。本研究的主要目的是对患者健康问卷（PHQ-9）和广泛性焦虑症量表（GAD-7）进行心理测量验证，以用于筛查寻求门诊治疗物质使用障碍的年轻人的抑郁和焦虑症状。我们的次要目的是比较 PHQ-9 和 GAD-7 及其更简短的两分量表（PHQ-2 和 GAD-2）在检测可能的情绪和焦虑障碍方面的表现。
从一家医院门诊物质使用障碍治疗项目的电子健康记录中提取数据，这些患者（年龄 14 至 26 岁）在临床实施 PHQ-9 和 GAD-7 后接受了诊断评估（N=121，平均年龄 19.1±3.1 岁）。
PHQ-9 和 GAD-7 表现出良好的内部一致性。在这些数据中，PHQ-9 得分 7 或 8（PHQ-2 得分：2）和 GAD-7 得分 6（GAD-2 得分：2）具有最佳的敏感性、特异性、阳性预测值和阴性预测值之间的平衡。这些措施也表现出良好的收敛性和可接受的判别有效性。
样本主要为白人和非西班牙裔，并且未使用经过验证的（半）结构化诊断访谈来确定情绪和焦虑障碍的诊断。
结果表明，PHQ-9 和 GAD-7 是可靠的，并且可能对患有物质使用障碍的年轻人的抑郁和焦虑具有临床应用价值，而两分量表可能与完整量表具有相似的临床效用。
