E. MAZZOTTI, G. FASSONE, A. PICARDI, E. SAGONI, L. RAMIERI, I. LEGA, D. CAMAIONI, D. ABENI, P. PASQUINI - Vol. 9, September 2003, Issue 3
Testo Immagini Bibliografia Summary Indice
Il Patient Health Questionnaire (PHQ) per
lo screening dei disturbi psichiatrici:
uno studio di validazione nei confronti della Intervista Clinica Strutturata
per il DSM-IV asse I (SCID-I)
The Patient Health Questionnaire (PHQ) for the screening of psychiatric
disorders:
a validation study versus the Structured Clinical Interview for DSM-IV axis
I (SCID-I)
Objective
Several studies pointed out that in non-psychiatric settings psychiatric
disorders are frequent, often underestimated, and inadequately treated. This
study examined the performance of the PHQ as a screener for depressive and
anxiety disorders in a sample of dermatological inpatients.
Methods
The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I)
was used as criterion standard. A total of 170 dermatological inpatients were
interviewed by a mental health professional within 48 hours of completing
the PHQ. The interviewers were not aware of the PHQ results.
Results
According to the SCID-I, 39% of patients had a psychiatric disorder, while
29% were positive to a PHQ diagnosis. The sensitivity and the specificity
of the PHQ were 46% and 92% for Major Depressive Disorder, 23% and 92% for
other depressive disorders, 17% and 97% for Panic Disorder, 9% and 95% for
other anxiety disorder, respectively. With the use of a modified diagnostic
algorithm (coding depressive symptoms simply as present or absent, without
taking frequency into account), the sensitivity in identifying major depression
improved substantially (89%).
Conclusion
Our study confirms a high rate of psychiatric morbidity among dermatological
patients. The operating characteristics of the Italian version of PHQ were
not fully satisfactory. Methodological differences may, at least in part,
explain the differences between our results and those of previous investigations
performed in other countries. However, our findings suggest that a possible
source of reduced performance may be represented by translation and transcultural
adaptation problems, particularly regarding the frequency of depressive symptoms.
If confirmed, our results might suggest the opportunity to refine the Italian
version of the instrument, in order to improve its performance.