验证患者健康问卷-4（PHQ-4）在希腊普通人群中筛查抑郁和焦虑。

Validation of the Patient Health Questionnaire-4 (PHQ-4) to screen for depression and anxiety in the Greek general population.

机构信息

Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece; Research Department of Clinical, Education and Health Psychology, University College London, UK.

出版信息

J Psychosom Res. 2022 Sep;160:110970. doi: 10.1016/j.jpsychores.2022.110970. Epub 2022 Jun 16.

DOI:10.1016/j.jpsychores.2022.110970

PMID:35728338

Abstract

OBJECTIVE

The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report screening scale for depression and anxiety with promising psychometric properties; however, its reliability and validity have not been investigated in Greece yet. The objective of the current study was to investigate the reliability and validity of the PHQ-4 and to establish a cut-off score to identify depression and anxiety in the Greek general population.

METHODS

The reliability of the PHQ-4 was assessed using a random sample of 204 students from Athens, Greece. The internal consistency (Cronbach's α) was evaluated whereas the test-retest reliability was measured over a one-week period with intra-class correlation (ICC). The scale's validity was assessed in a cross-sectional study of 591 adults living in Greece using confirmatory factor analysis (CFA). Cut-offs were determined using the Mini International Neuropsychiatric Interview (MINI) as the gold standard.

RESULTS

Cronbach's α of the PHQ-4 was 0.80 and the overall ICC 0.96. CFA yielded a two-factor model, structurally invariant by age and gender. A GAD-2 score of 2 was the optimal cut-off point to detect any anxiety disorder (sensitivity = 0.82, specificity = 0.75) and 3 to detect generalized anxiety disorder (sensitivity = 0.77, specificity = 0.82). As for PHQ-2, a score of 2 was the optimal cut-off point to detect any depressive disorder (sensitivity = 0.87, specificity = 0.85) and 3 to detect major depressive disorder (sensitivity = 0.77, specificity = 0.94).

CONCLUSIONS

The PHQ-4 is a reliable and valid screening scale for depression and anxiety in the Greek general population.

摘要

目的

患者健康问卷-4（PHQ-4）是一种用于筛查抑郁和焦虑的超简短自评量表，具有良好的心理测量学特性；然而，其在希腊的可靠性和有效性尚未得到研究。本研究的目的是调查 PHQ-4 的可靠性和有效性，并确定一个切点来识别希腊普通人群中的抑郁和焦虑。

方法

使用来自希腊雅典的 204 名学生的随机样本评估 PHQ-4 的可靠性。评估内部一致性（Cronbach's α），并在一周内使用组内相关系数（ICC）测量重测信度。使用验证性因子分析（CFA）在希腊的 591 名成年人中进行横断面研究评估该量表的效度。使用 Mini 国际神经精神访谈（MINI）作为金标准确定切点。

结果

PHQ-4 的 Cronbach's α 为 0.80，总 ICC 为 0.96。CFA 得出了一个两因素模型，在年龄和性别上具有结构不变性。GAD-2 得分为 2 是检测任何焦虑障碍的最佳切点（敏感性=0.82，特异性=0.75），3 是检测广泛性焦虑障碍的最佳切点（敏感性=0.77，特异性=0.82）。对于 PHQ-2，2 分是检测任何抑郁障碍的最佳切点（敏感性=0.87，特异性=0.85），3 分是检测重度抑郁障碍的最佳切点（敏感性=0.77，特异性=0.94）。