Grupo de investigación Neurociencias, Universidad de Santander (UDES), Bucaramanga, Colombia.
Instituto de Salud de Bucaramanga (ISABU), Hospital local del Norte, Bucaramanga, Colombia.
Rev Colomb Psiquiatr (Engl Ed). 2021 Jan-Mar;50(1):11-21. doi: 10.1016/j.rcp.2019.09.001. Epub 2020 Jan 25.
The patient health questionnaire-9 (PHQ-9) is one of the most widely used self-report instruments in primary care. There is no criterion validity of the PHQ-9 in Colombia. The objective was to validate the PHQ-9 as a screening tool in primary care. A cross-sectional, scale criterion validity study was performed using as reference criterion the mini neuropsychiatric interview (MINI) in male and female adult users of primary care centres. We calculated the internal consistency and convergent and criterion validity of the PHQ-9 by analysing the receiver operating characteristics (ROC) and the area under the curve (AUC). We analysed 243 participants; 184 (75.7%) were female. The average age was 34.05 (median of 31 and SD = 12.47). Cronbach's α was 0.80 and McDonald's ω was 0.81. Spearman's Rho was 0.64 for HADS-D (P <0.010) and 0.70 for PHQ-2 (P <0.010). The AUC was 0.92 (95% CI 0.880-0.963). The optimal cut-off point of PHQ-9 was ≥7: sensitivity of 90.38 (95% CI: 81.41-99.36); specificity of 81.68 (95% CI: 75.93-87.42); PPV 57.32 (95% CI: 46.00-68.63); NPV 96.89 (95% CI: 93.90-99.88); Youden index 0.72 (95% CI: 0.62-0.82); LR+ 4.93 (95% CI: 3.61-6.74); LR- 0.12 (95% CI: 0.005-0.270). In sum, the Colombian version of PHQ-9 is a valid and reliable instrument for depression screening in primary care in Bucaramanga, with a cut-off point ≥7.
患者健康问卷-9（PHQ-9）是初级保健中使用最广泛的自我报告工具之一。在哥伦比亚，PHQ-9 没有效标效度。本研究的目的是验证 PHQ-9 在初级保健中作为筛查工具的适用性。采用横断面、量表效标效度研究方法，以男性和女性初级保健中心使用者为研究对象，采用迷你神经精神访谈（MINI）作为参考标准。我们通过分析受试者工作特征（ROC）曲线和曲线下面积（AUC），计算 PHQ-9 的内部一致性、收敛性和效标效度。我们分析了 243 名参与者，其中 184 名（75.7%）为女性，平均年龄为 34.05 岁（中位数为 31，标准差为 12.47）。Cronbach's α 为 0.80，McDonald's ω 为 0.81。Spearman's Rho 分别为 0.64（HADS-D，P<0.010）和 0.70（PHQ-2，P<0.010）。AUC 为 0.92（95% CI 0.880-0.963）。PHQ-9 的最佳截断点为≥7：敏感性为 90.38%（95% CI：81.41%-99.36%）；特异性为 81.68%（95% CI：75.93%-87.42%）；阳性预测值为 57.32%（95% CI：46.00%-68.63%）；阴性预测值为 96.89%（95% CI：93.90%-99.88%）；约登指数为 0.72（95% CI：0.62%-0.82%）；阳性似然比为 4.93（95% CI：3.61%-6.74%）；阴性似然比为 0.12（95% CI：0.005%-0.270%）。总之，哥伦比亚版 PHQ-9 是布卡拉曼加初级保健中用于抑郁筛查的有效、可靠的工具，截断点≥7。
