Jie Yuan1, Rongjing Ding2, Li Wang3, Li Sheng4, Jianchao Li5, Dayi Hu6. 1. Department of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, China. Electronic address: yuanjiemxcg@163.com. 2. Heart Center of Peking University People's Hospital, Beijing 100044, China. Electronic address: drj2003@vip.163.com. 3. Department of Cardiology, Yong Chuan Hospital Affiliated to Chongqing Medical University, Chongqing 400042, China. Electronic address: 419923286@qq.com. 4. Department of psychology, United family health care, Beijing 100102, China. Electronic address: shengli@bjmu.edu.cn. 5. School of Biological and Medical Engineering, Beihang University, Beijing 100083, China. Electronic address: lee1111@163.com. 6. Department of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, China. Electronic address: doctorhudayi@sina.com.
Abstract
OBJECTIVE: To assess the reliability and criterion validity of Patient Health Questionnaire-9 (PHQ-9) versus Hospital Anxiety and Depression Scale-Depression (HADS-D) as screening instruments for depression in patients with the acute coronary syndrome (ACS). METHODS: A total of 782 patients were recruited from four local hospitals. All of them completed the questionnaires of PHQ-9 and HADS-D. The measures of PHQ-9 and HADS-D were validated against the Mini International Neuropsychiatric Interview (MINI), a gold diagnostic criterion for major depressive disorder (MDD). RESULTS: Based upon the MINI, the prevalence of MDD was 15.6% in Chinese ACS patients. Two scales demonstrated excellent internal consistencies (Cronbach's α > 0.8). The diagnostic accuracy of PHQ-9 and HADS-D for diagnosing MDD was moderate with areas under receiver operating characteristics (ROC) curve of 0.842 (95%CI: 0.806-0.894) and 0.813 (95%CI: 0.767-0.852), respectively. The optimal cutoff points of PHQ-9 and HADS-D for screening MDD were 10 and 9, respectively. Comparing the operating characteristics of PHQ-9 and HADS-D, the specificity was similar (84.7% vs. 85.5%, p = .40) while the sensitivity of PHQ-9 was significantly higher than HADS-D (86.9% vs. 76.2%, p = .001). CONCLUSION: Chinese versions of PHQ-9 and HADS-D are reliable and valid screening instruments for MDD in ACS patients. The PHQ-9 performs better in minimizing missed diagnoses.
OBJECTIVE: To assess the reliability and criterion validity of Patient Health Questionnaire-9 (PHQ-9) versus Hospital Anxiety and Depression Scale-Depression (HADS-D) as screening instruments for depression in patients with the acute coronary syndrome (ACS). METHODS: A total of 782 patients were recruited from four local hospitals. All of them completed the questionnaires of PHQ-9 and HADS-D. The measures of PHQ-9 and HADS-D were validated against the Mini International Neuropsychiatric Interview (MINI), a gold diagnostic criterion for major depressive disorder (MDD). RESULTS: Based upon the MINI, the prevalence of MDD was 15.6% in Chinese ACS patients. Two scales demonstrated excellent internal consistencies (Cronbach's α > 0.8). The diagnostic accuracy of PHQ-9 and HADS-D for diagnosing MDD was moderate with areas under receiver operating characteristics (ROC) curve of 0.842 (95%CI: 0.806-0.894) and 0.813 (95%CI: 0.767-0.852), respectively. The optimal cutoff points of PHQ-9 and HADS-D for screening MDD were 10 and 9, respectively. Comparing the operating characteristics of PHQ-9 and HADS-D, the specificity was similar (84.7% vs. 85.5%, p = .40) while the sensitivity of PHQ-9 was significantly higher than HADS-D (86.9% vs. 76.2%, p = .001). CONCLUSION: Chinese versions of PHQ-9 and HADS-D are reliable and valid screening instruments for MDD in ACS patients. The PHQ-9 performs better in minimizing missed diagnoses.