家庭医生甄别抑郁症ScreeningofDepressionbyFamilyDoctors郑.ppt

设计 --- 将《基层医疗精神疾病评估工具(PRIME-MD)》中2Q及PHQ-9 翻译成中文。 在 14 所普通科医务所，由357位候诊病人填写问卷。 Design --- The 2Q and the PHQ-9 questionnaires from the Primary Care Evaluation of Mental Disorders Procedure (PRIME-MD) were translated into Chinese. 357 Patients from 14 general practice clinic in Hong Kong were asked to fill in the questionnaires before they saw their doctors. 另外医生在不知结果的情况下，对病人采用 17 项问题中文版汉米尔顿抑郁表(CHDS) 评估，以此作为诊断抑郁症的标准，再为2Q及PHQ-9结果验证其有效性。 The general practitioners, blind to the results, then applied the 17 items Chinese Hamilton Depression Rating Scale (CHDS) for the patients. The 2Q and the PHQ-9 were then validated against the CHDS, which served as the gold standard for depression detection. 主要测量内容 2Q及PHQ-9 的灵敏度及特异度 PHQ-9及CHDS之间的皮尔逊相关性(Pearson Correlation)。 Main outcome measures Sensitivity and specificity of the 2Q and PHQ-9 Pearson Correlation between the PHQ-9 and CHDS 结果 2Q灵敏度为96.7%，特异度为73.4%。 PHQ-9 (当分界点为9) 灵敏度为 80%，特异度为92%。 PHQ-9及CHDS 之间皮尔逊相关性为0.793 (p0.01)。 Results Sensitivity and specificity of the 2Q were 96.7% and 73.4% respectively. Sensitivity and specificity of the PHQ-9 at cut-off point of 9 were 80% and 92% respectively. Pearson Correlation between the PHQ-9 and the CHDS was 0.793 (p0.01). 2Q问卷 在过去的一个月，您曾否经常被以下事情烦扰： 　　是 否 几乎没有兴趣去做事 □ □ 感觉情绪低落、抑郁或绝望 □ □ PHQ-9 问卷 表一：填写问卷病人性别与年龄Table 1: Subject Characteristics: Sex Age Male Female Total Age Mean SD N Mean SD N Mean SD N 40.96 13.100 134 40.57 13.451 212 40.89 13.294 357 表二：2Q 灵敏度及特异度Table 2: Sensitivity and Specificity of 2Q 灵敏度＝96.7% 特异度＝73.4% Sensibility=96.7% Specificity=73.4% CHDS ≦ 16 CHDS 16 Total 2Q = 0 240 1 241 2Q 0 87 29 116 Total 327 30 357 表三： PHQ-9 灵敏度及特异度Table 3: Sensitivity and Specificity of PHQ-9 灵敏度(当分界点为9)＝80% 特异度＝92% Sensibility (cut-off point=9)=80% Specificity=92% CHDS ≦ 16 CHDS 16 Total PHQ-9≦9 301 6 307 PHQ-9 9 26 24 50 Total 327 30 357 图一：CHDS及 PHQ-9 相互关系 Graph 1: Correlation between CHDS and PHQ-9 CHDS 及 PHQ-9 相互关系