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A study of the diagnostic accuracy of the PHQ-9 in primary care elderly

机译：PHQ-9在基层医疗老年人中的诊断准确性研究

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Background The diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depression in elderly persons in primary care settings in the United States has not been previously addressed. Thus, the purpose of this study was to evaluate the test performance of the PHQ-9 for detecting major and minor depression in elderly patients in primary care. Methods A prospective study of diagnostic accuracy was conducted in two primary care, university-based clinics in the Pacific Northwest of the United States. Seventy-one patients aged 65 years or older participated; all completed the PHQ-9 and the 15-item Geriatric Depression Scale (GDS) and underwent the Structured Clinical Interview for Depression (SCID). Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, and likelihood ratios (LRs) were calculated for the PHQ-9, the PHQ-2, and the 15-item GDS for major depression alone and the combination of major plus minor depression. Results Two thirds of participants were female, with a mean age of 78 and two chronic health conditions. Twelve percent met SCID criteria for major depression and 13% minor depression. The PHQ-9 had an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.74-1.00) for major depression, while the PHQ-2 and the 15-item GDS each had an AUC of 0.81 (95% CI for PHQ-2, 0.64-0.98, and for 15-item GDS, 0.70-0.91; P = 0.551). For major and minor depression combined, the AUC for the PHQ-9 was 0.85 (95% CI, 0.73-0.96), for the PHQ-2, 0.80 (95% CI, 0.68-0.93), and for the 15-item GDS, 0.71 (95% CI, 0.55-0.87; P = 0.187). Conclusions Based on AUC values, the PHQ-9 performs comparably to the PHQ-2 and the 15-item GDS in identifying depression among primary care elderly.
机译：背景技术在美国，以前没有讨论过患者健康问卷9（PHQ-9）在评估老年人初级保健机构中的抑郁症时的诊断准确性。因此，本研究的目的是评估PHQ-9在初级保健中检测老年患者的重度和轻度抑郁的测试性能。方法在美国西北太平洋地区的两家基层大学大学诊所进行了诊断准确性的前瞻性研究。参加研究的年龄在65岁以上的71名患者;所有受试者均完成了PHQ-9和15项老年抑郁量表（GDS），并接受了结构性抑郁症临床访谈（SCID）。计算PHQ-9，PHQ-2和15个项的GDS的敏感性，特异性，接受者工作特征（ROC）曲线下方的面积（LRs）以及仅合并主要抑郁症的15个项的GDS轻度抑郁。结果三分之二的参与者为女性，平均年龄为78岁，有两种慢性病。百分之十二的人符合重度抑郁的SCID标准，而轻度抑郁的满足13％。对于严重抑郁症，PHQ-9的曲线下面积（AUC）为0.87（95％置信区间[CI]，0.74-1.00），而PHQ-2和15个项的GDS的AUC均为0.81（ PHQ-2的95％CI为0.64-0.98,15项GDS的CI为0.70-0.91; P = 0.551）对于重度和轻度抑郁症，PHQ-9的AUC为0.85（95％CI，0.73-0.96），PHQ-2的AUC为0.80（95％CI，0.68-0.93），以及15个项目的GDS ，0.71（95％CI，0.55-0.87; P ＝ 0.187）。结论根据AUC值，PHQ-9在识别初级保健老年人中的抑郁症方面与PHQ-2和15个项目的GDS相当。

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