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.
J Psychosom Res. 2022 Sep;160:110970. doi: 10.1016/j.jpsychores.2022.110970. Epub 2022 Jun 16.
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.
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.
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).
The PHQ-4 is a reliable and valid screening scale for depression and anxiety in the Greek general population.
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。
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。
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）。
PHQ-4 是一种可靠且有效的用于希腊普通人群中筛查抑郁和焦虑的量表。
