患者健康问卷抑郁量表在中医内科门诊对抑郁障碍的筛查价值

摘要

目的:探讨患者健康问卷抑郁量表(PHQ-9)在中医内科门诊对抑郁障碍的筛查价值. 方法:采用连续门诊调查方式,对2009例中医内科门诊18 ～ 65岁患者进行PHQ-9自评,并采用简明神经精神访谈工具(MINI)对患者进行精神检查. 结果:以MINI结果为金标准,本组PHQ-9评分的ROC曲线下面积为0.903(95％ CI:0.869 ～0.937);以8分为临界值时中医内科门诊患者的抑郁障碍筛查的敏感性和特异性分别为0.856和0.802.有抑郁障碍、焦虑障碍、慢性躯体疾病患者的PHQ-9评分显著高于无相应疾病的患者(P =0.036 ～0.000).抑郁症状越严重,患者的门诊次数越多、因躯体或心理疾病缺勤的时间越长,抑郁症状引起困难的比率越高(P均=0.000). 结论:以8分为临界值,PHQ-9对中医内科门诊患者的抑郁障碍筛查具有较高的信度和效度.%Objective:To evaluate the screening value of the patient health questionnaire depression scale (PHQ-9) in outpatients from traditional Chinese internal department.Method:By continuous clinic investigation,2009 outpatients from internal department of traditional Chinese medicine were self-evaluated with PHQ-9; and also received psychiatric interview by mini international neuropsychiatric interview(MINI).Results:The MINI results as the gold standard,the area under the receiver operator charactristic analysis (ROC) of PHQ-9 was 0.903 (95％ CI:0.869-0.937).With 8 into the critical value for depression screening in outpatients from internal department of traditional Chinese medicine,the sensitivity was 0.856 and specificity was 0.802,respectively.The score of PHQ-9 in the patients with depressive disorder,anxiety disorder or chronic somatic diseases were significantly higher than patients without corresponding diseases (P =0.036-0.000).The heavier the depression symptoms in patient,the more times to clinic and longer absences from work due to physical or mental sickness,and the higher the ratio of difficulty caused by depression symptoms (all P =0.000).Conclusion:PHQ-9 has a higher reliability and validity for depression screening in outpatients from traditional Chinese internal department with 8 into the critical value.