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印尼患者健康问卷在精神科门诊中的临床应用:根据 ICD-11 标准排除疾病。

Indonesian patient health questionnaire's clinical utility in psychiatric outpatients: Ruling out conditions per ICD-11 criteria.

机构信息

Faculty of Psychology, Universitas Indonesia, Depok, Indonesia; Indonesian Psychological Healthcare Center, Jakarta, Indonesia.

Indonesian Psychological Healthcare Center, Jakarta, Indonesia; Faculty of Psychology, Universitas Gadjah Mada, Yogyakarta, Indonesia.

出版信息

Asian J Psychiatr. 2024 Oct;100:104184. doi: 10.1016/j.ajp.2024.104184. Epub 2024 Jul 27.

Abstract

This study aimed to assess the diagnostic accuracy of the Patient Health Questionnaire (PHQ) for identifying common mental disorders in an outpatient clinical psychologist office setting in Indonesia. A total of 661 outpatients from a clinical psychology office in Jakarta, Indonesia, participated in the study. The complete PHQ was administered, and its results were compared with diagnoses made by clinical psychologists based on ICD-11 criteria, including somatoform disorder (n = 6), depression (n = 117), Generalized Anxiety Disorder (GAD, n = 50), panic disorder (n = 42), bulimia nervosa (n = 2), binge eating disorder (n = 2), and other diagnoses such as OCD and BPD (n = 442). Receiver operating characteristics were computed to examine cut-off points, and optimal cut-off points based on the Youden Index were identified for somatoform disorder (PHQ-15 ≥ 13), depression (PHQ-9 ≥ 13), GAD (GAD- 7 ≥ 10), and panic disorder (PHQ-PD ≥ 7). Cut-off points for the alcohol abuse and eating disorder modules of the PHQ could not be determined due to a lack of sample, and AUC was suboptimal for PHQ-9, GAD-7, and PHQ-ED. The Indonesian PHQ demonstrated good sensitivity but low specificity in identifying somatoform disorder, depression, GAD, and panic disorders based on ICD-11 criteria among Indonesian clinical psychologist office outpatients. In the Indonesian outpatient psychiatric context, the utility of the Indonesian PHQ appeared to be most effective in ruling out diagnoses.

摘要

本研究旨在评估患者健康问卷(PHQ)在印度尼西亚门诊临床心理学家办公室环境中识别常见精神障碍的诊断准确性。共有 661 名来自印度尼西亚雅加达临床心理科办公室的患者参与了这项研究。进行了完整的 PHQ 评估,并将其结果与临床心理学家根据 ICD-11 标准做出的诊断进行比较,包括躯体形式障碍(n=6)、抑郁症(n=117)、广泛性焦虑障碍(GAD,n=50)、惊恐障碍(n=42)、贪食症(n=2)、暴食障碍(n=2)以及强迫症和边缘型人格障碍等其他诊断(n=442)。计算了受试者工作特征曲线,以检查截断值,并根据约登指数确定躯体形式障碍(PHQ-15≥13)、抑郁症(PHQ-9≥13)、GAD(GAD-7≥10)和惊恐障碍(PHQ-PD≥7)的最佳截断值。由于样本量不足,无法确定 PHQ 中酒精滥用和饮食障碍模块的截断值,并且 PHQ-9、GAD-7 和 PHQ-ED 的 AUC 较差。基于 ICD-11 标准,印度尼西亚 PHQ 在识别印度尼西亚临床心理学家办公室门诊患者中的躯体形式障碍、抑郁症、GAD 和惊恐障碍方面具有良好的敏感性,但特异性较低。在印度尼西亚门诊精神科环境中,印度尼西亚 PHQ 的效用似乎最有效地排除诊断。

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