Reliability and validity of the ultra-brief screening scale for depression and anxiety in outpatients clinics of community healthcare centers

doi:10.16138/j.1673-6087.2021.02.010

Abstract

Abstract:

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.

Key words: The ultra-brief screening scale for depression and anxiety, Patient health questionnaire 4, Reliability, Validity, Community healthcare center outpatients

CLC Number:

R749.7

QIAN Jie, JIANG Minmin, CHEN Chen, CHEN Yujiao, YU Dehua, LI Chunbo. Reliability and validity of the ultra-brief screening scale for depression and anxiety in outpatients clinics of community healthcare centers[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(02): 116-120.

Figures/Tables 4

References 24

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类别	性别		年龄（岁）				婚姻状况			文化程度
类别	男性	女性	<60	60~69	≥70	缺失	在婚	未婚丧离	缺失	初中及以下	高中	大学及以上	缺失
例数[n（%）]	117(37.4)	196(62.6)	60(19.2)	103(32.9)	146(46.6)	4(1.3)	275(87.9)	34(10.9)	4(1.3)	103(32.9)	98(31.3)	105(33.5)	7(2.2)
PHQ-4（分）	1.38±1.85	1.34±1.93	0.72±1.22	1.27±1.89	1.71±2.07	-	1.28±1.74	2.03±2.82	-	1.46±2.26	1.83±1.83	0.89±1.46	-

PHQ-4	条目1	条目2	条目3	条目4	PHQ-2总分	GAD-2总分	PHQ-4总分
条目1	1.000
条目2	0.600	1.000
条目3	0.505	0.669	1.000
条目4	0.547	0.562	0.566	1.000
PHQ-2总分	0.907	0.880	0.650	0.619	1.000
GAD-2总分	0.586	0.704	0.929	0.831	0.717	1.000
PHQ-4总分	0.823	0.864	0.837	0.770	0.941	0.910	1.000