Abstract
BackgroundThis study aimed to explore the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) on screening of depression among patients with neurological disorders, and to explore factors influencing such patients.MethodsIn this study, 277 subjects who were admitted to the department of neurology of our hospital due to different neurological disorders completed the PHQ-9 questionnaire. The Mini-International Neuropsychiatric Interview (MINI) and Hamilton Rating Scale for Depression (HAMD) were employed to evaluate the depressive symptoms of patients who completed the PHQ-9 questionnaire. The internal consistency, criterion validity, structural validity, and optimal cut-off values of PHQ-9 were evaluated, and the consistency assessment was conducted between the depression severity as assessed by PHQ-9, HAMD and MINI. Logistic regression analysis was used to calculate the risk factors of depression.ResultsThe Cronbach’s α coefficient of the PHQ-9 was 0.839. The Pearson’s correlation coefficient among the 9 items of the PHQ-9 scale was 0.160 ~ 0.578 (P < 0.01), and the Pearson’s correlation coefficient between each item and the total score was at the range of 0.608 ~ 0.773. Taking the results of MINI as the gold standard, the area under the receiver operating characteristic (ROC) curve of the PHQ-9 results for all the subjects (n = 277) was 0.898 (95% confidence interval (CI): 0.859 ~ 0.937, P < 0.01). When the cut-off score was equal to 5, the values of sensitivity, specificity, and the Youden’s index were 91.2, 76.6%, and 0.678, respectively. Multivariate logistic regression analysis showed that the influence of unemployment on the occurrence of depression was statistically significant (P = 0.027, OR = 3.080, 95%CI: 1.133 ~ 8.374).ConclusionsThe application of PHQ-9 for screening of depression among Chinese patients with neurological disorders showed a good reliability and validity.
Highlights
Mental disorder, called mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning [1]
As for medical expenses, 271 (97.8%) cases were covered by health insurance, while 6 (2.2%) cases were at their own expenses
Multivariate logistic regression analysis showed that the influence of unemployment on the occurrence of depression was statistically significant (P = 0.027, odds ratio (OR) = 3.080, 95%Confidence Interval (CI): 1.133 ~ 8.374)
Summary
Called mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning [1]. Depression, as an important mental disorder, was ranked as the third cause of burden of disease worldwide in 2008 and may rank first by 2030 [2]. Depression, which often accompanies multiple diseases, imposes serious health and economic burdens to society [3, 4]. There are multiple ways in which depression can be identified. As for mild forms of depression, it may recover without much clinical assistance or only need primary care. Identifying cases with depression that require advanced care is a main challenge to primary care, and for clinicians, especially for nonpsychiatric physicians. This study aimed to explore the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) on screening of depression among patients with neurological disorders, and to explore factors influencing such patients
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