Clinical Researches
Application of Patient Health Questionnaire-4 in the evaluation of depression and anxiety status of inpatients in general hospitals
Wang Qingqing, Qian Ruilian, Chen Zhaohong, Gao Ying, Xu Hua, Zhang Hanyue
Published 2023-07-16
Cite as Chin J Mod Nurs, 2023, 29(20): 2723-2727. DOI: 10.3760/cma.j.cn115682-20220614-02844
Abstract
ObjectiveTo evaluate the feasibility of using Patient Health Questionnaire-4 (PHQ-4) to screen for depression and anxiety in inpatients in general hospitals.
MethodsUsing the convenient sampling method, a total of 695 inpatients from 10 ClassⅡ Grade A and above comprehensive hospitals in Nanjing from January to June 2021 were selected as the research objects. They were investigated by PHQ-4, Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) to compare the screening results of different measuring tools for depression and anxiety. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of PHQ-4, Kappa test was used to analyze the consistency, Cronbach's α coefficient was used to evaluate the internal consistency of the scale, and Pearson correlation analysis was used to evaluate the calibration correlation validity. A total of 695 questionnaires were sent out in this study, and 672 were effectively collected, with an effective recovery rate of 96.69% (672/695) .
ResultsAmong 672 inpatients in general hospitals, the detection rate of depression and anxiety in patients using PHQ-4 was 38.39% (258/672), while that in patients using PHQ-9 and GAD-7 was 41.82% (281/672), and the difference showed no statistical significance (χ2=1.64, P=0.20). Cronbachs'α coefficient of PHQ-4 was 0.913, and the half reliability coefficient was 0.888. The Kappa value of the consistency test between PHQ-4, PHQ-9, and GAD-7 for depression and anxiety screening results was 0.756 (P<0.01). The correlation coefficients between the total scores of PHQ-4, PHQ-9 and GAD-7 in 672 inpatients from general hospitals were 0.822 and 0.802, respectively (both P<0.01). The area under the ROC curve of PHQ-4 was 0.936. With a critical score of 3, the sensitivity and specificity of PHQ-4 were 81.9% and 92.8%, respectively.
ConclusionsThe detection rate of PHQ-4 and PHQ-9 and GAD-7 on depression and anxiety state of inpatients in general hospital is similar, and has good reliability and validity, which is suitable for the screening of depression and anxiety of inpatients in general hospital.
Key words:
Depression; Anxiety; Patient Health Questionnaire-4; Patient Health Questionnaire-9; Generalized Anxiety Disorder-7; General hospital; Inpatients
Contributor Information
Wang Qingqing
Department of Nursing, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
Qian Ruilian
Department of Nursing, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
Chen Zhaohong
Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
Gao Ying
Department of Medical Psychology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
Xu Hua
Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
Zhang Hanyue
Department of Medical Psychology, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
