病人健康问卷抑郁量表在青少年中的应用  

Application analysis of the 9-item Patient Health Questionnaire in adolescents

作　　者：魏艳萍 崔宝今 薛将[1] 陈树林[1] 黄泽军 Wei Yanping;Cui Baojin;Xue Jiang;Chen Shulin;Huang Zejun(Department of Psychology and Behavioral Sciences,Zhejiang University,Hangzhou 310007,China;Hangzhou Institute of Educational Science,Hangzhou 310003,China)

机构地区：[1]浙江大学心理与行为科学系,浙江杭州310007 [2]杭州市教育科学研究院,浙江杭州310003

出　　处：《四川精神卫生》2023年第2期149-155,共7页Sichuan Mental Health

摘　　要：目的探讨病人健康问卷抑郁量表(PHQ-9)在不同性别和年龄的青少年人群中的测量等值性以及评分分布特点,检验PHQ-9用于比较不同性别和年龄的青少年抑郁水平的可行性。方法于2018年9月-2019年5月,基于整群抽样法,纳入杭州市22所中小学的12241名10~19岁的青少年为研究对象,采用PHQ-9进行调查。通过多组验证性因素分析检验测量等值性,采用Poisson回归分析、Logistic回归分析等探讨PHQ-9评分在年龄和性别上的分布情况。结果PHQ-9在性别上的形态等值、弱等值、强等值和严格等值性模型(χ^(2)=2492.527,df=79,P<0.01,RMSEA=0.071,SRMR=0.031,CFI=0.942,TLI=0.947,与强等值性模型的ΔCFI=0.004,ΔTLI=0.002)均可被接受,在年龄上的形态等值、弱等值和强等值性模型(χ^(2)=3311.991,df=414,P<0.01,RMSEA=0.076,SRMR=0.055,CFI=0.928,TLI=0.937,与弱等值性模型的ΔCFI=0.010,ΔTLI=0.002)均可被接受。女生的轻度抑郁症状检出率高于男生(52.99%vs.46.65%,χ^(2)=48.344,P<0.01);13~17岁女生PHQ-9总评分均高于男生(D=0.092~0.144,P均<0.01);性别与年龄存在交互作用(χ^(2)=32.800,df=1,P<0.01,OR=0.895)。除自我评价低与自杀或自伤外,女生在PHQ-9每个条目评估症状上的检出率均高于男生(P均<0.05)。结论PHQ-9在青少年人群中具有跨性别、跨年龄的测量等值性,女生和更高年龄的青少年人群PHQ-9评分更高。Objective To investigate the measurement invariance and the score distribution characters of the 9-item Patient Health Questionnaire(PHQ-9),and to test its feasibility in comparing depression among adolescents of different sexes and ages.Methods From September 2018 to May 2019,12241 adolescents aged 10 to 19 years old across 22 primary and secondary schools in Hangzhou were included based on cluster sampling method,and they were investigated by PHQ-9.The measurement invariance was tested by multi-group confirmatory factor analysis.Poisson regression analysis and Logistic regression analysis were adopted to explore the score distribution of PHQ-9 by sex and age.Results The configural,metric,scalar and strict invariances(χ^(2)=2492.527,df=79,P<0.01,RMSEA=0.071,SRMR=0.031,CFI=0.942,TLI=0.947,ΔCFI=0.004,ΔTLI=0.002 compared with the scalar model)of PHQ-9 across sex were all acceptable,and the configural,metric and scalar invariances(χ^(2)=3311.991,df=414,P<0.01,RMSEA=0.076,SRMR=0.055,CFI=0.928,TLI=0.937,ΔCFI=0.010,ΔTLI=0.002 compared with the metric model)across age were acceptable.The detection rate of mild depressive symptoms in girls was higher than that in boys(52.99%vs.46.65%,χ^(2)=48.344,P<0.01).The PHQ-9 total scores of girls aged 13 to 17 were higher than those of boys(D=0.092~0.144,P<0.01).There was an interaction between sex and age(χ^(2)=32.800,df=1,P<0.01,OR=0.895).Except low self-evaluation and suicide or self-injury,the detection rate of assessed symptom on each item of girls was higher than that of boys(P<0.05).Conclusion It is discovered that PHQ-9 has measurement equivalence across sex and age in adolescents,and girls and older adolescents scored higher in PHQ-9.

关 键 词：抑郁 青少年 PHQ-9 性别 年龄 

分 类 号：R749.4[医药卫生—神经病学与精神病学]