The Application Of PHQ-9 And GAD-7 Scales In Mental Assessment Of Functional Gastrointestinal Diseases

Objective:Through the application of Patient Health Questionnaire – 9(PHQ-9)and Generalized Anxiety Disorder – 7(GAD-7)in the anxiety and depression status of patients with Functional Gastrointestinal Disorders(FGIDs),the application value of PHQ-9 and GAD-7 in the screening of anxiety and depression status of patients with FGIDs were discussed.Methods:This research is divided into two parts,Part I: 67 patients with FGIDs admitted to the department of gastroenterology of guangxi zhuang autonomous region people's hospital from October 2017 to October 2018 were selected to collect their general demographic information under the condition of informed consent,and the patients independently finished the PHQ-9 and GAD-7 psychological scale as well as by the professional trained physicians who interviewed patients with HAMA and HAMD scale assessment;Part II: 158 patients with FGIDs admitted to the department of gastroenterology of guangxi zhuang autonomous region people's hospital from October 2016 to October 2018 were selected.All patients completed the PHQ-9 scale independently,which was evaluated and diagnosed by the department of psychiatry or trained professional doctors as the "gold standard" for diagnosis.The sensitivity and specificity of PHQ-9 were statistically analyzed,reliability and validity tests were conducted,and ROC curve was drawn to determine the optimal cut-off value of PHQ-9 for screening depression.Results:?.A total of 67 FGIDs patients were included in the study.1.The detection rates of depression and anxiety in patients with FGIDs by PHQ-9 and GAD-7 scales were 73.1% and 62.7%,respectively,which were significantly higher than28.4% of HAMD and 44.8% of HAMA(P < 0.05).There was no significant statistical significance in the detection rate of depression and anxiety at different levels.2.The coincidence rates of PHQ-9 and GAD-7 with HAMD and HAMA were 55.22%and 64.18%,respectively.3.The coincidence rate between PHQ-9 and the diagnosis by clinicians was 56.7%,lower than that of HAMD(62.7%).The coincidence rate of GAD-7 diagnosis with clinician was 38.8%,lower than 53.7% in HAMA,but P>0.05,the difference was not statistically significant.4.After Kappa consistency test,Kappa value of PHQ-9 and HAMD scale was 0.254,P<0.05;Kappa value of GAD-7 and HAMA scale was 0.302,P<0.05,both scales were consistent,but the consistency was low.5.Spearman correlation test showed that the correlation coefficient between PHQ-9 total score and HAMD total score was 0.616,P < 0.001,which shows a significant positive correlation.The correlation coefficient between GAD-7 total score and HAMA total score was0.632,P < 0.001,showing a significant positive correlation.6.Gender and age of FGIDs patients had no significant influence on the scores of PHQ-9and GAD-7(P > 0.05).?.A total of 158 FGIDs patients were included in the study.1.Reliability evaluation: Cronbach's ? was 0.826 by reliability analysis;Using Pearson correlation analysis,the PHQ-9 items showed a significant positive correlation with the total score,with the r values of 0.722,0.785,0.565,0.611,0.544,0.695,0.678,0.674,and 0.556,respectively,and the P values were all less than 0.01.2.Validity evaluation: a principal component factor was extracted by using the principal component analysis method.The characteristic root was 3.889,and the contribution rate was43.216%.After rotation by the maximum variance method,the characteristic root is 3.892,the contribution rate is 43.248%,and the factor loading matrix coefficient of this factor and eachitem is between 0.485 and 0.809.Consistency test of PHQ-9 and gold standard: Kappa consistency test showed that Kappa value was 0.329,P<0.001.Determination of the optimal cutoff value: the area under the ROC curve was 0.761,with a statistically significant difference from 0.5,and the 95% confidence interval was between0.688 and 0.834.When the cut-off value was 6 points or highter,Youden index was the largest.Conclusion:1.PHQ-9 and GAD-7 can effectively screen and evaluate the anxiety and depression status of FGIDs patients.2.PHQ-9 is an effective tool for screening depression in FGIDs patients,and the recommended best cut-off value is 6 points or highter.