PHQ-9 对艾滋病病毒感染者抑郁症精神诊断的准确性:一项多县横断面研究。

IF 3.4 2区 医学 Q3 IMMUNOLOGY AIDS Pub Date : 2024-10-01 Epub Date: 2024-06-26 DOI:10.1097/QAD.0000000000003963
Marcel Yotebieng, Natalia Zotova, Charlotte Bernard, Suzanne Goodrich, Ajeh Rogers Awoh, Dana Watnick, Dominique Mahambu Nsonde, Elodie Flore Tchiengang Moungang, Julie Laure Nguemo Noumedem, Guy Calvin Nko'o Mbongo'o, Albert Minga, Moussa Seydi, Paul Gandou, Edith Kamaru Kwobah, Lukoye Atwoli, Antoine Jaquet, Kara Wools-Kaloustian, Kathryn Anastos
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引用次数: 0

摘要

研究目的本研究旨在评估 9 项患者健康问卷(PHQ-9)与精神病医生对 PLWH 诊断的对比情况:对2018年1月至2022年7月期间在喀麦隆、科特迪瓦、肯尼亚、塞内加尔和刚果共和国五个地点收集的数据进行横断面分析。参与者年龄≥18 岁,并在参与地点接受艾滋病护理。研究人员对参与者进行PHQ-9测试,然后在3天内由精神科医生进行评估:共有 778 名参与者提供了完整的数据:喀麦隆有 297 人(38.2%),刚果有 132 人(17.0%),科特迪瓦有 148 人(19.0%),肯尼亚有 98 人(12.6%),塞内加尔有 103 人(13.2%)。PHQ-9 评分的曲线下面积普遍较高,科特迪瓦为 0.935(95% CI:0.893,0.977),刚果为 0.768(95% CI:0.589,0.947)。然而,对于常用的截断分数≥10,灵敏度较低:喀麦隆、刚果和塞内加尔为 50%或更低,肯尼亚为 66.7%,科特迪瓦为 70.6%。但阴性预测值(NPV)很高:喀麦隆为 98.9%(95% CI:96.9%,99.8%),科特迪瓦为 96.1(95% CI:91.1,98.7),肯尼亚为 96.3%(95% CI:89.7%,99.2%),刚果为 95.7%(95% CI:90.2%,98.6%),塞内加尔为 89.0%(95% CI:81.2%,94.4%):在所有国家中,PHQ-9 评分≥10 分的人作为精神科医生诊断抑郁症的识别工具表现很差(灵敏度低)。然而,观察到的高 NPV 表明它可用于排除抑郁症。
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Accuracy of nine-item Patient Health Questionnaire against psychiatric diagnosis for depression among people with HIV.

Objective: The aim of this study was to assess the performance of the nine-item Patient Health Questionnaire (PHQ-9) against psychiatrist diagnosis in people with HIV (PWH).

Design: Cross-sectional analysis of data collected between January 2018 and July 2022 across five sites in Cameroon, Cote d'Ivoire, Kenya, Senegal, and the Republic of Congo. Participants were ≥18 years and receiving HIV care at the participating site. PHQ-9 was administered by study staff followed by a psychiatrist's evaluation within 3 days.

Results: Overall, 778 participants with complete data were included: 297 (38.2%) in Cameroon, 132 (17.0%) in Congo, 148 (19.0%) in Cote d'Ivoire, 98 (12.6%) in Kenya, and 103 (13.2%) in Senegal. The area under the curve for PHQ-9 score was generally high ranging from 0.935 [95% confidence interval (CI): 0.893, 0.977] in Cote d'Ivoire to 0.768 (95% CI: 0.589, 0.947) in Congo. However, for the common cut-off score ≥10, sensitivity was low: 50% or lower in Cameroon, Congo and Senegal, 66.7% in Kenya and 70.6% in Cote d'Ivoire. But negative predictive values (NPV) were high: 98.9% (95% CI: 96.9%, 99.8%) in Cameroon, 96.1 (95% CI: 91.1, 98.7) in Cote d'Ivoire, 96.3% (95% CI: 89.7%, 99.2%) in Kenya, 95.7% (95% CI: 90.2%, 98.6%) in Congo, and 89.0% (95% CI: 81.2%, 94.4%) in Senegal.

Interpretation: Across all countries, PHQ-9 score ≥10 performed very poorly (low sensitivity) as a tool to identify psychiatrist diagnosed depression. However, the observed high NPV suggests it can be used to rule out depression.

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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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