Martínez Pablo, Soto-Brandt Gonzalo, Brandt Sebastián, Guajardo Viviana, Rojas Graciela
Departamento de Psiquiatría y Salud Mental, Hospital Clínico, Universidad de Chile, Santiago, Chile.
Escuela de Salud Pública, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2020 Nov;148(11):1614-1618. doi: 10.4067/S0034-98872020001101614.
Patient Health Questionnaire (PHQ-9) has nine questions and is used in diabetic or hypertensive patients to detect depressive symptoms. The PHQ-2 uses the first two questions of the PHQ-9 to rapidly detect those patients that should answer the whole questionnaire.
To validate the PHQ-2 to detect depressive symptoms in diabetic or hypertensive patients consulting at Primary Health Care (PHC).
Secondary analysis of data obtained during the baseline assessment of a clinical trial. Diabetic and hypertensive patients aged 18 years or more, attending a public health care clinic of Metropolitan Santiago, were invited to participate. Those accepting, answered the Patient Health Questionnaire (PHQ-9), consisting in nine questions about depressive symptoms. Demographics and health data were also collected. The PHQ-2 capacity to discriminate PHQ-9 scores equal or higher than 10 and 15 and the correlation between both versions, were assessed.
Ninety-four participants aged 64 ± years (73% women) answered the questionnaire. A cut-off score of 3 or more points in the PHQ-2 achieved the best tradeoff between sensitivity and specificity for discriminating PHQ-9 scores equal or higher than 10 (area under the receiver operating characteristic curve (ROC) = 0.92, 95% confidence interval [95% CI] = 0.87 to 0.97) and 15 points (area under the ROC curve = 0.95, 95% CI = 0.92 to 0.99). Both versions had a high positive correlation (r = 0.87).
The PHQ-2 allows a stepped, simple and accurate screening for depressive symptoms. Diabetic or hypertensive patients with 3 or more points should be immediately assessed with the remaining questions of the PHQ-9.
患者健康问卷（PHQ - 9）有九个问题，用于糖尿病或高血压患者以检测抑郁症状。PHQ - 2使用PHQ - 9的前两个问题来快速检测那些应回答完整问卷的患者。
验证PHQ - 2在初级卫生保健（PHC）就诊的糖尿病或高血压患者中检测抑郁症状的有效性。
对一项临床试验基线评估期间获得的数据进行二次分析。邀请年龄在18岁及以上、在圣地亚哥大都会的公共卫生保健诊所就诊的糖尿病和高血压患者参与。接受邀请的患者回答患者健康问卷（PHQ - 9），该问卷包含九个关于抑郁症状的问题。还收集了人口统计学和健康数据。评估了PHQ - 2区分PHQ - 9得分等于或高于10分和15分的能力以及两个版本之间的相关性。
94名年龄为64±岁（73%为女性）的参与者回答了问卷。PHQ - 2中3分或更高的截断分数在区分PHQ - 9得分等于或高于10分（受试者工作特征曲线（ROC）下面积 = 0.92，95%置信区间[95%CI] = 0.87至0.97）和15分（ROC曲线下面积 = 0.95，95%CI = 0.92至0.99）时，在敏感性和特异性之间实现了最佳权衡。两个版本具有高度正相关（r = ）。
PHQ - 2允许对抑郁症状进行逐步、简单且准确的筛查。PHQ - 2得分为3分或更高的糖尿病或高血压患者应立即用PHQ - 9的其余问题进行评估。
