RESUMO
BACKGROUND: The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. METHODS: We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. RESULTS: One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach's alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson's correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6-8 for mild cases, 9-14 for moderate and 15 or more for severe depressive symptoms respectively. CONCLUSIONS: The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.
Assuntos
Transtorno Depressivo/diagnóstico , Questionário de Saúde do Paciente/normas , Adulto , Argentina , Estudos Transversais , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente/estatística & dados numéricos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de DoençaRESUMO
Over the last decades a series of psychological treatments labeled <
Assuntos
Terapia de Aceitação e Compromisso , Transtornos Mentais/terapia , Behaviorismo , Humanos , Atenção PlenaRESUMO
Clinical work with patient suffering complex or multiple problems represents one of the biggest challenges for mental health professionals. The third wave of cognitive behavioral therapies emphasizes the context and function of psychological events more so than their validity, frequency, or form, while incorporating processes of acceptance and mindfulness. The current work aims to provide a description of one type of these therapies, Dialectical Behavioral Therapy (DBT), which was developed by Dr. Marsha M. Linehan. In the 80's DBT's efficacy was investigated among women diagnosed with borderline personality disorder, while later extending the model to be used for other disorders. Specifically, the orientation of DBT, the central dialectic component between acceptance and change, validation procedures, and changes are explained. Moreover, the biosocial theory of the etiology and maintenance of behavioral problems are considered. Lastly, the targeted problems specific to when they occurred and their components for treatment are explained in stages.