地域に関連したPrimary Health Questionaire-9 症状陽性率の検討 : 玉樹(中国)、土佐町(日本)の比較

Abstract

[Background] The way people feel bad is different according to the culture. Although group related bias named differential item functioning (DIF) is studied in various scales including depression scale, DIF has not been studied in primary health questionnaire-9(PHQ-9), which is translated into over 80 languages. We evaluated DIF of PHQ-9 at Yushu (China) and Tosa(Japan). [Methods] Among the participants of health check-up program (Yushu; n=184, Tosa; n=305), those who were positive in one of the two question depression screening questions were included in our study (Yushu; n=44, Tosa: n=132). Certified psychiatrist checked PHQ-9 and answers of each item were dichotomized. [Results] Positive rate in Q1 (interest loss), Q2 (depressed mood), Q4 (easy fatigability) and Q6 (self-reproach) were greater in Yushu compared with Tosa after adjustment of age. Positive rates in Q3 and Q4 were high in Tosa and those in Q1, Q2, Q4 and Q5 were high in Yushu. [Conclusion] DIF related to the regions were seen in Yushu and Tosa town. The contributing items to the diagnosis of major depression were different according to the region. As the phenotype of major depression could be different in each region, we should be aware of them in the diagnosis and intervention.