【摘要】 目的分析在类风湿关节炎患者中使用患者健康问卷抑郁量表(PHQ-9)、患者健康问卷躯体症状群量表(PHQ-15)与汉密尔顿抑郁量表17项(HAMD-17)筛查合并抑郁障碍的患者并比较3种评价方法的相关性。方法选取广州市第一人民医院门诊就诊的类风湿关节炎患者120例,使用HAMD-17对患者进行评估,同时指导患者采用PHQ-9、PHQ-15进行自我评估,分析3种量表的内部一致性信度及抑郁结果判定的相关性,采用组内相关系数检验及一致性Kappa检验了解结果判定的一致性。结果 3种量表的克朗巴哈系数均大于0.7,提示其内部一致性程度高。相关性分析提示3种量表两两密切相关。对3种量表总分进行组内相关系数检验,提示一致性非常好[ICC=0.856(0.750,0.922),P<0.01]。将评估结果分等级行一致性Kappa分析,显示PHQ-9与HAMD-17存在结果一致性(χ~2=0.281,P<0.01),PHQ-15与HAMD-17结果一致性较差(χ~2=0.099,P>0.05)。结论 PHQ-9、PHQ-15与HAMD-17在抑郁严重程度上具有较高的相关性,能够在类风湿关节炎患者中进行抑郁障碍早期筛查,为临床诊疗提供依据和参考。更多还原

【Abstract】 Objective To analyze the correlation between Patient Health Questionnaire Depression Scale(PHQ-9),Patient Health Questionnaire Somatic Symptom Scale(PHQ-15),and Hamilton Depression Scale 17(HAMD-17)in assessing the severity of depression in patients with rheumatoid arthritis. Methods 120 patients with rheumatoid arthritis were treated in the outpatient department of Guangzhou First People′s Hospital. The patients were evaluated with HAMD-17. At the same time,patients were instructed to use PHQ-9 and PHQ-15 for self-assessment. The three scales were analyzed. The internal consistency of HAMD-17 total score,PHQ-9 total score and PHQ-15 total score was evaluated by intraclass correlation efficient(ICC). The consistency of the ordered categorical variables of both scales was analyzed by kappa coefficient.Results The Cronbach′α of all three scales were greater than 0.7,suggesting a high degree of internal consistency. Correlation analysis suggested that the three scales were closely related. The intraclass correlation coefficient test on the total scores of the three scales showed that the consistency was very good [ICC=0.856(0.750,0.922),P<0.01]. Kappa analysis showed that there was consistency of results between PHQ-9 and HAMD-17(χ~2=0.281,P 0.01),and poor consistency of results between PHQ-15 and HAMD-17(χ~2=0.099,P>0.05). Conclusion PHQ-9,PHQ-15 and HAMD-17 are highly correlated in the severity of depression,and can be used for early screening of depression in patients with rheumatoid arthritis,providing a basis and reference for clinical diagnosis and treatment.更多还原