Psychosomatic medicine · 2013
Comparison of depressive symptoms in type 2 diabetes using a two-stage survey design.
СтатьяПоддержка исследования: вне правительства СШАВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Twist Katherine, Stahl Daniel, Amiel Stephanie A, Thomas Stephen, Winkley Kirsty, Ismail Khalida
Аннотация
OBJECTIVE: To test the validity of the Patient Health Questionnaire-9 (PHQ-9) in adults with newly diagnosed Type 2 diabetes mellitus (T2DM) and compare the distribution of PHQ-9 items in those with and without Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) depression.
METHODS: A two-stage survey design was used in primary care centers (n = 96). In Stage 1, participants were administered the PHQ-9 and biopsychosocial measures. In Stage 2, PHQ-9 positives (score ≥ 10) and randomly selected PHQ-9 negatives (score <10) had a diagnostic interview, Schedule for Clinical Assessment in Neuropsychiatry 2.1. The sensitivity, specificity and receiver operating characteristics of the PHQ-9 were calculated. The means of PHQ-9 items were compared.
RESULTS: Stage 1: Prevalence of PHQ-9 positives (completing Stage 2) was 12.1% (n = 182). PHQ-9 positives were younger (mean [standard deviation] age = 52.8 [9.47] versus 56.2 [11.50] years, p < .001) and had higher body mass index (32.7 [7.08] versus 31.6 [6.25] kg/m(2), p = .028) than PHQ-9 negatives (n = 1278). Stage 2: Prevalence of DSM-IV depression was 5.6% (n = 84). The optimal cutoff was ≥ 12 (sensitivity = 86.9%, specificity = 80.3%). PHQ-9 true positives scored significantly higher than PHQ-9 false positives on all items, excluding sleep (mean [standard deviation] score = 2.4 [0.98] versus 2.2 [1.06]), fatigue (2.5 [0.80] versus 2.3 [0.86]), and appetite (1.6 [1.23] versus 1.5 [1.26]).
CONCLUSIONS: Over-identification of depression by PHQ-9 in T2DM may be driven by presence of symptoms in keeping with an organic origin.
METHODS: A two-stage survey design was used in primary care centers (n = 96). In Stage 1, participants were administered the PHQ-9 and biopsychosocial measures. In Stage 2, PHQ-9 positives (score ≥ 10) and randomly selected PHQ-9 negatives (score <10) had a diagnostic interview, Schedule for Clinical Assessment in Neuropsychiatry 2.1. The sensitivity, specificity and receiver operating characteristics of the PHQ-9 were calculated. The means of PHQ-9 items were compared.
RESULTS: Stage 1: Prevalence of PHQ-9 positives (completing Stage 2) was 12.1% (n = 182). PHQ-9 positives were younger (mean [standard deviation] age = 52.8 [9.47] versus 56.2 [11.50] years, p < .001) and had higher body mass index (32.7 [7.08] versus 31.6 [6.25] kg/m(2), p = .028) than PHQ-9 negatives (n = 1278). Stage 2: Prevalence of DSM-IV depression was 5.6% (n = 84). The optimal cutoff was ≥ 12 (sensitivity = 86.9%, specificity = 80.3%). PHQ-9 true positives scored significantly higher than PHQ-9 false positives on all items, excluding sleep (mean [standard deviation] score = 2.4 [0.98] versus 2.2 [1.06]), fatigue (2.5 [0.80] versus 2.3 [0.86]), and appetite (1.6 [1.23] versus 1.5 [1.26]).
CONCLUSIONS: Over-identification of depression by PHQ-9 in T2DM may be driven by presence of symptoms in keeping with an organic origin.
Предметные рубрики MeSH
AdolescentAdultAgedDepressive DisorderDiabetes Mellitus, Type 2Diagnostic and Statistical Manual of Mental DisordersFalse Positive ReactionsFemaleHealth SurveysHumansInterview, PsychologicalMaleMiddle AgedPrevalencePrimary Health CareProspective StudiesSensitivity and SpecificitySeverity of Illness IndexSurveys and QuestionnairesUnited KingdomYoung Adult