验证《患者健康问卷-9》的英文和斯瓦希里文适应版本在肯尼亚青少年中的适用性。

Validation of the English and Swahili Adaptation of the Patient Health Questionnaire-9 for Use Among Adolescents in Kenya.

机构信息

Department of Psychiatry, University of Nairobi, Nairobi, Kenya; Department of Clinical Psychology, Vrije Universiteit, Amsterdam, the Netherlands.

Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Adolesc Health. 2023 Jan;72(1S):S61-S70. doi: 10.1016/j.jadohealth.2022.10.003. Epub 2022 Nov 12.

DOI:10.1016/j.jadohealth.2022.10.003

PMID:36376148

Abstract

PURPOSE

Our study aimed to validate culturally adapted English and Swahili versions of the Patient Health Questionnaire-9 (PHQ-9) for use with adolescents in Kenya. Criterion validity was determined with clinician-administered diagnostic interviews using the Kiddie Schedule of Affective Disorders and Schizophrenia.

METHODS

A total of 250 adolescents comprising 148 (59.2%) females and 102 (40.8%) males aged 10-19 years (mean = 14.76; standard deviation = 2.78) were recruited. The PHQ-9 was administered to all respondents concurrently in English and Swahili. Adolescents were later interviewed by clinicians using Kiddie Schedule of Affective Disorders and Schizophrenia to determine the presence or absence of current symptoms of major depressive disorder. Sensitivity specificity, positive predictive value (PPV) and negative predictive value (NPV), and likelihood ratios for various cut-off scores for PHQ-9 were analyzed using receiver operating characteristic curves.

RESULTS

The internal consistency (Cronbach's α) for PHQ-9 was 0.862 for the English version and 0.834 for Swahili version. The area under the curve was 0.89 (95% confidence interval, 0.84-0.92) and 0.87 (95% confidence interval, 0.82-0.90) for English and Swahili version, respectively, on receiver operating characteristic analysis. A cut-off of ≥ 9 on the English-language version had a sensitivity of 95.0%, specificity of 73.0%, PPV of 0.23, and NPV of 0.99; a cut-off of ≥ 9 on the Swahili version yielded a sensitivity of 89.0%, specificity of 70.0%, PPV of 0.20, and NPV of 0.90.

DISCUSSION

Psychometric properties were comparable across both English-adapted and Swahili-adapted version of the PHQ-9, are reliable, and valid instrument to detect major depressive disorder among adolescents which can be used in resource-limited settings for early identification of adolescents in need of mental health support.

摘要

目的

本研究旨在验证经文化调适后的英文版和斯瓦希里语版患者健康问卷-9（PHQ-9）在肯尼亚青少年中的适用性。采用儿童心境障碍和精神分裂症谱系与评估定式检查（Kiddie Schedule of Affective Disorders and Schizophrenia）对临床医生进行诊断访谈，以确定效标效度。

方法

共招募了 250 名 10-19 岁（平均=14.76；标准差=2.78）的青少年，其中 148 名（59.2%）为女性，102 名（40.8%）为男性。所有受访者同时用英语和斯瓦希里语填写 PHQ-9。之后，由临床医生使用儿童心境障碍和精神分裂症谱系评估对青少年进行访谈，以确定是否存在或不存在当前的重度抑郁症症状。使用受试者工作特征曲线分析 PHQ-9 不同临界值的灵敏度、特异性、阳性预测值（PPV）、阴性预测值（NPV）和似然比。

结果

PHQ-9 的英文版本的内部一致性（Cronbach's α）为 0.862，斯瓦希里语版本为 0.834。在受试者工作特征分析中，英文和斯瓦希里语版本的曲线下面积分别为 0.89（95%置信区间，0.84-0.92）和 0.87（95%置信区间，0.82-0.90）。在英文版本中，临界值≥9 的灵敏度为 95.0%，特异性为 73.0%，PPV 为 0.23，NPV 为 0.99；在斯瓦希里语版本中，临界值≥9 的灵敏度为 89.0%，特异性为 70.0%，PPV 为 0.20，NPV 为 0.90。