Related Factors Of Depression After Acute Cerebral Infarction And Reliability And Validity Of PHQ-9 In Acute Cerebral Infarction

Objective:To investigate the incidence of depression in acute cerebral infarction,to explore the factors affecting the depression state of patients with acute cerebral infarction,and to test the reliability and validity of the Patient Health Questionnaire Depression Scale(PHQ-9)in acute cerebral infarction.Methods:Select the patient who was hospitalized in neurology in the Fourth Affiliated Hospital of China Medical University from January 2017 to April 2018,Improve DWI and identify patients was the frist time of acute cerebral infarction.Investigate the general condition,clinical data and past history of the patient,in the case of informed consent of the patient,measuring depression status in patients with PHQ-9 and HAMD at 1 month,3 months,and 6 months after onset.At the same time,CCMD-3 is the standard for diagnosing PSD.After PHQ-9 initial measurement for two weeks,40 patients were randomly selected for PHQ-9 retest.To understand the incidence and influencing factors of depression in patients with acute cerebral infarction and to analyze the reliability and validity of PHQ-9 in this population.Result:1.A total of 144 patients with acute cerebral infarction were evaluated in this study,and diagnosed PSD patients base on CCMD-3 in 1 month,3 months,and 6 months after infarction was 25,18,7,the total was 50,and the incidence rate were 17.36%,12.5% and6.31%.2.Studies have shown that factors affecting the incidence of depression in acute cerebral infarction include more than 60 years old,NIHSS score at admission,speech disorder,thrombolysis/surgical treatment,number of lesions,and history of coronary heart disease.3.The Cronbach's ? coefficient of the total score of the PHQ-9 scale is 0.743,and the Pearson correlation coefficient of each item and the total score is 0.217-0.904,and the correlation coefficient between the items is 0.161-0.824,all have a correlation.The correlation coefficient between the frist test of PHQ-9 and 2 weeks after retesting is0.773.Pearson correlation analysis was performed on the total score of PHQ-9 and the total score of HDAM,the correlation coefficients at 1 month,3 months,and 6 months were 0.931,0.917,and 0.759.After the principal component factor analysis,twocommon factors were obtained,which were cognitive-emotional factors and somatic symptom factors.4.When PHQ-9 assessed the depression value as 3 points,the Yoden index was 0.901,the sensitivity was 96%,the specificity was 94.1%,and the area under the ROC curve was0.989.When PHQ-9 assessed the depressive mood with a cut-off value of 5,the Yoden index was 0.672,the sensitivity was 68%,the specificity was 99.2%,and the diagnostic coincidence rate with CCMD-3 was 93.1%,Kappa=0.841,P<0.001.Conclusion:1.More than 60 years old,admission NIHSS score,speech disorder,thrombolysis/surgical treatment,number of lesions,and coronary heart disease had significant effects on depression in patients with acute cerebral infarction,and the difference was statistically significant(P < 0.05).2.PHQ-9 has good reliability and validity in the evaluation of depression in patients with acute cerebral infarction,and has good consistency with CCMD-3.