Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.
Center for Functional GI & Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
J Psychosom Res. 2024 May;180:111654. doi: 10.1016/j.jpsychores.2024.111654. Epub 2024 Mar 30.
Using the large Rome Foundation Global Epidemiology Survey dataset, the aim of this study was to evaluate the construct and convergent validity and internal consistency of the PHQ-4 across both gastrointestinal and non-gastrointestinal condition cohorts. Another aim was to provide descriptive information about the PHQ-4 including means, confidence intervals and percentage of caseness using a large representative sample.
A cross-sectional survey was conducted in 26 countries. Confirmatory factor and internal consistency analyses were conducted across subsamples of patients with gastrointestinal conditions (i.e., disorders of gut-brain interaction [DGBI; any DGBI, individual DGBI, and DGBI region], gastroesophageal reflux disease (GERD), coeliac disease, diverticulitis, inflammatory bowel disease (IBD), cancer anywhere in the gastrointestinal tract, peptic ulcer) and those without a gastrointestinal condition. Convergent validity was also assessed via a series of Pearson's correlation coefficients with PROMIS (physical and mental quality of life), and PHQ-12 (somatisation).
Based on 54,127 participants (50.9% male; mean age 44.34 years) confirmatory factor analysis indicated acceptable to excellent model fits for the PHQ-4 across all subsamples and individual DGBI and DGBI region (Comparative Fit Index >0.950, Tucker-Lewis Index >0.950, Root Mean Squared Error of Approximation <0.05, and Standardised Root Mean Square Residual <0.05). The PHQ-4 was found to demonstrate convergent validity (Pearson's correlation coefficients >±0.4), and good internal consistency (Cronbach's α > 0.75).
This study provides evidence that the PHQ-4 is a valid and reliable tool for assessing mental health symptomology in both gastrointestinal and non-gastrointestinal cohorts.
利用罗马基金会全球流行病学调查的大型数据集，本研究旨在评估 PHQ-4 在胃肠道和非胃肠道疾病队列中的结构和收敛效度以及内部一致性。另一个目的是使用大样本提供 PHQ-4 的描述性信息，包括平均值、置信区间和病例百分比。
在 26 个国家进行了横断面调查。在胃肠道疾病患者（即肠脑相互作用障碍[DGBI；任何 DGBI、个体 DGBI 和 DGBI 区域]、胃食管反流病（GERD）、乳糜泻、憩室炎、炎症性肠病（IBD）、胃肠道任何部位的癌症、消化性溃疡）和无胃肠道疾病的患者亚组中进行了确认性因子和内部一致性分析。通过一系列与 PROMIS（身体和心理健康生活质量）和 PHQ-12（躯体化）的 Pearson 相关系数来评估收敛效度。
基于 54127 名参与者（50.9%为男性；平均年龄 44.34 岁），确认性因子分析表明，PHQ-4 在所有亚组和个体 DGBI 和 DGBI 区域的模型拟合均为可接受至优秀（比较拟合指数>0.950，塔克-刘易斯指数>0.950，根均方误差逼近<0.05，标准化根均方残差<0.05）。PHQ-4 表现出收敛效度（Pearson 相关系数>±0.4）和良好的内部一致性（Cronbach's α>0.75）。
本研究提供了证据表明，PHQ-4 是一种在胃肠道和非胃肠道队列中评估心理健康症状的有效和可靠工具。
