目的：初步探讨中文版超简抑郁焦虑筛查量表[4条目患者健康问卷（patient health questionnaire 4,PHQ-4）]在社区门诊患者中的信度与效度。方法：在上海2家社区卫生服务中心门诊随机抽取313例患者,由1名精神科主治医师和经过培训的2名全科医师,使用规定指导语帮助患者完成PHQ-4自评,并进行汉密尔顿抑郁量表（Hamilton depression scale,HAMD）和汉密尔顿焦虑量表（Hamilton anxiety scale,HAMA）评定,最后采用国际神经精神科简式访谈问卷进行访谈。初次评定后7~14 d内,随机抽取其中50例患者进行PHQ-4重测。对PHQ-4的内在一致性信度、重测信度、效标效度和结构效度等进行计算分析;并进行受试者工作特征曲线（receiver operating characteristic curve, ROC曲线）分析确定最佳分界值,计算灵敏度、特异度等。结果：PHQ-4的内在一致性信度克龙巴赫α系数（Cronbach’α系数）为0.833, 折半信度的Spearman-Brown系数为0.835。重测信度计算组内相关系数（intraclass correlation coefficient,ICC）为0.969。PHQ-4总分与HAMD、HAMA总分的相关系数分别为0.391和0.407,差异均具有统计学意义（P<0.01）。ROC分析得出曲线下面积（area under curve,AUC）为0.919,最佳分界值为3分。PHQ-4的灵敏度和特异度分别为87.1%和82.6%。结论：中文版PHQ-4在社区门诊患者中具有较好的信度和效度,适合抑郁、焦虑的筛查。

Objective To preliminary evaluate the reliability and validity of the ultra-brief screening scale for depression and anxiety [patient health questionnaire 4 (PHQ-4)] in outpatients clinics of community healthcare centers. Methods Totally 313 patients were randomly selected from two community healthcare centers in Shanghai. The patients were asked to complete the PHQ-4 following the prescribed instruction with assistance of a psychiatrist and two physicians, and then were evaluated according Hamilton depression scale(HAMD) and the Hamilton anxiety scale(HAMA) followed by a mini international neuropsychiatric interview(MINI). Out of subjects screened, 50 patients were randomly selected to retest the PHQ-4. The reliability coefficients, retest reliability and criterion validity sensitivity and specificity were calculated. The receiver operating characteristic(ROC) analysis was performed to determine the best cut-off value, and the sensitivity and specificity accordingly. Results The Cronbach’α coefficient of PHQ-4 was 0.833, the Spearman-Brown coefficient of the split-half reliability was 0.835. For the test-retest reliability, the intraclass correlation coefficient (ICC) was 0.969. The correlation coefficients of generalized anxiety disorder 7(GAD-7) with HAMD and HAMA were 0.391 and 0.407 respectively, both statistically significant (P<0.01). ROC analysis showed that the area under curve(AUC) was 0.919, and the best cut-off value was 3, the sensitivity and specificity of PHQ-4 were 87.1% and 82.6% respectively. Conclusions The Chinese version of the PHQ-4 maintains high reliability and validity in outpatient clinics of community healthcare centers, and is suitable for the screening of depression and anxiety.