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PHQ-9 与HAMD-17 在抑郁症评估中的 相关性
周娇娇王巍巍朱雪泉陈旭
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摘要:
目的 分析患者健康问卷抑郁量表(PHQ-9)与汉密尔顿抑郁量表17 项(HAMD-17)在评 估抑郁症严重程度中的相关性。方法 选取北京安定医院门诊就诊的抑郁症患者115 例,使用HAMD- 17 对抑郁症患者进行严重程度评估,同时指导患者采用PHQ-9 进行自我评估,采用组内相关系数(ICC) 评价HAMD-17 总分和PHQ-9 总分的内部一致性,采用加权Kappa对两个有序的多分类变量进行一致性 检验,采用Spearman 秩相关性分析两者各维度的相关性。结果 两量表总分一致性良好[ICC=0.657 (0.504,0.763),P < 0.01];Kappa分析结果显示两组各级别严重程度之间存在相关性,但一致性较差 [Kappa=0.313(0.197,0.430),P< 0.01];HAMD-17 和PHQ-9 在抑郁情绪维度无相关性(P> 0.05);HAMD- 17 和PHQ-9 在自杀、睡眠、体质、全身症状、兴趣及自责等维度呈正相关(P< 0.05),且在自杀维度相关 性较好(r=0.62)。结论 PHQ-9 与HAMD-17 在抑郁症严重程度上具有较高的相关性,能够进行抑郁症 早期筛查及自杀风险预测,为临床诊疗提供依据和参考。
关键词:  抑郁症  患者健康问卷抑郁量表  汉密尔顿抑郁量表17 项  门诊患者
DOI:10.3969/j.issn.1009-6574.2019.02.006
基金项目:国家重点研发计划(2016YFC1307200);北京市医院管理局重点医学专业发展计划 (ZYLX201607);北京市医院管理局“登峰”人才培养计划(DFL20151801)
Correlation analysis between PHQ-9 and HAMD-17 in assessing the severity of depression
()
Abstract:
Objectives To analyze the correlation between Patient Health Questionaire-9( PHQ-9) and Hamilton Depression Scale-17( HAMD-17) in assessing the severity of depression. Methods A total of 115 patients with depression were selected from the outpatient care of Bejing Anding Hospital. HAMD- 17 was used to assess the severity of depression, and all patients were also instructed to conduct PHQ-9 selfassessment. The internal consistency of HAMD-17 total score and PHQ-9 total score was evaluated by intraclass correlation efficient( ICC). The consistency of the ordered categorical variables of both scales was analyzed by weighted kappa coefficient. The correlation of the dimensions of both scales was assessed by Spearman rank correlation coefficient. Results PHQ-9 and HAMD-17 had a good consistency[ ICC=0.657(0.504, 0.763), P < 0.01]. Kappa analysis showed that there was a correlation between the severity of the two groups at all levels, but the consistency across two scales was poor[ Kappa=0.313(0.197, 0.430), P < 0.01]. HAMD-17 and PHQ-9 showed correlation in the dimensions of suicide, sleep, constitution, systemic symptoms, interest and self-blame( P<0.05). Particularly, there was a good correlation in suicide( r=0.62). However, there was no correlation in depressed mood( P>0.05). Conclusions The PHQ-9 and HAMD scales have a high correlation in assessing the severity of depression. They can be used for early screening and suicide risk prediction of depression, providing a basis and reference for clinical diagnosis and treatment.
Key words:  Depressive disorder  Patient Health Questionnaire  Hamilton Depression Scale-17  Outpatients

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