Department of Endocrinology, Sengkang General Hospital, Singapore.
Department of Endocrinology, Changi General Hospital, Singapore.
J Diabetes Investig. 2023 Sep;14(9):1128-1135. doi: 10.1111/jdi.14051. Epub 2023 Jul 6.
AIMS/INTRODUCTION: Depression is prevalent in diabetes patients and associated with poor outcomes, but is currently underdiagnosed, with no firm consensus on screening methods. We evaluated the validity of the short-form five-item Problem Areas in Diabetes (PAID-5) questionnaire as a screening tool for depression, comparing it with the Beck Depression Inventory-II (BDI-II) and nine-item Patient Health Questionnaire (PHQ-9).
A total of 208 English-speaking adults with type 2 diabetes, recruited from outpatient clinics, completed the BDI-II, PHQ-9 and PAID-5 questionnaires in English. Cronbach's α was used for internal reliability. Convergent validity was examined with BDI-II and PHQ-9. Receiver operating characteristics analyses were used to identify optimal PAID-5 cut-offs for the diagnosis of depression.
All three screening tools were highly reliable, with BDI-II, PHQ-9 and PAID-5 having a Cronbach's α of 0.910, 0.870 and 0.940, respectively. There was a good correlation between BDI-II and PHQ-9, with a correlation co-efficient (r) of 0.73; and a moderate correlation between PAID-5 and PHQ-9, and PAID-5 and BDI-II, with r of 0.55 and 0.55 respectively (P values <0.01). An optimal PAID-5 cut-off ≥9 corresponded to both a BDI-II cut-off >14 (sensitivity 72%, specificity 784%, area under the curve 0.809) and a PHQ-9 cut-off >10 (sensitivity 84%, specificity 74%, area under the curve 0.806). Using a PAID-5 cut-off ≥9, the prevalence of depressive symptoms was 36.1%.
Depressive symptoms are prevalent in people with type 2 diabetes, with the degree of distress significantly related to the severity of depressive symptoms. PAID-5 is a valid and reliable screening tool, and a score ≥9 could prompt further confirmation for depression.
目的/引言：抑郁症在糖尿病患者中很常见，与不良结局相关，但目前诊断不足，对于筛查方法也没有明确共识。我们评估了简短的五分量表糖尿病问题领域（PAID-5）问卷作为一种筛查工具的有效性，将其与贝克抑郁量表二（BDI-II）和九分量表患者健康问卷（PHQ-9）进行比较。
共有 208 名英语为母语的 2 型糖尿病门诊患者完成了 BDI-II、PHQ-9 和 PAID-5 问卷调查。采用 Cronbach's α 评估内部信度。使用 BDI-II 和 PHQ-9 评估了聚合效度。采用受试者工作特征分析确定 PAID-5 用于诊断抑郁症的最佳截断值。
所有三种筛查工具都具有高度可靠性，BDI-II、PHQ-9 和 PAID-5 的 Cronbach's α 分别为 0.910、0.870 和 0.940。BDI-II 和 PHQ-9 之间相关性良好，相关系数（r）为 0.73；PAID-5 与 PHQ-9 和 BDI-II 之间存在中度相关性，r 分别为 0.55 和 0.55（P 值均<0.01）。PAID-5 最佳截断值≥9 与 BDI-II 截断值>14（灵敏度 72%，特异性 784%，曲线下面积 0.809）和 PHQ-9 截断值>10（灵敏度 84%，特异性 74%，曲线下面积 0.806）均相关。使用 PAID-5 截断值≥9，抑郁症状的患病率为 36.1%。
2 型糖尿病患者中抑郁症状很常见，其痛苦程度与抑郁症状的严重程度显著相关。PAID-5 是一种有效且可靠的筛查工具，得分≥9 可能提示需要进一步确认抑郁症。
