The Adaption Of PHQ-15 Scale In Functional Dyspepsia Patients And Its Clinical Application

Objective: To adapt the Patient Healthy Questionnaire-15(PHQ-15)measured somatization in functional dyspepsia patients,investigate the reliability and validity of the questionnaire and evaluate the clinical application effect.Methods: 25 common non-gastrointestinal somatic symptoms included in PHQ-15 and other questionnaires for somatization assessment were selected to constitute the item pool of the initial adapted PHQ-15.498 FD patients completed the initial adapted PHQ-15,PHQ-15,Dyspepsia Symptoms Severity(DSS),Nepean Dyspepsia Index–Short Form(NDI),Patient Healthy Questionnaire-9(PHQ-9)and Generalized Anxiety Disorders-7(GAD-7).The 25 items were analyzed through four methods based on dispersion,correlation coefficient,factor analysis,and Cronbach’s α,and 15 items were selected to constitute the item pool of the adapted PHQ-15.Reliability analysis and validity analysis were carried for adapted PHQ-15,PHQ-15 and PHQ-12.To explore the relation between anxiety,depression,somatization and quality of life.To observe the conventional therapeutic effect after 4 weeks,and study the influential factors for FD.Results: Cronbach’s α coefficient of adapted PHQ-15,PHQ-15 and PHQ-12 were 0.772,0.661,and 0.652 respectively.Test-retest reliability of adapted PHQ-15,PHQ-15 and PHQ-12 were(r=0.961,P=0.000),(r=0.933,P=0.000),and(r=0.916,P=0.000)respectively.Criteria validity of adapted PHQ-15 was(r=0.872,P=0.000).Four factors were extracted of adapted PHQ-15,cumulative contribution was 50.501%,four factors were extracted of PHQ-15,cumulative contribution was 48.681%,three factors were extracted of PHQ-12,cumulative contribution was 49.757%.The results of four-factor model showed χ~2=147.779,RMR=0.017,RMSEA=0.044,GFI=0.953,AGFI=0.933,CFI=0.909,TLI=0.886,NFI=0.834 of adapted PHQ-15;χ~2=165.444,RMR=0.017,RMSEA=0.050,GFI=0.949,AGFI=0.928,CFI=0.860,TLI=0.826,NFI=0.737 of PHQ-15.The patients whose somatization scores ≥10 were 162(41.0%)of adapted PHQ-15 and 131(33.2%)of PHQ-15,the difference was significant(χ~2=5.213,P=0.022).Anxiety was associated with somatization measured by adapted PHQ-15(r=0.509,P=0.000),PHQ-15(r=0.491,P=0.000)and PHQ-12(r=0.457,P=0.000);depression was associated with somatization measured by adapted PHQ-15(r=0.608,P=0.000),PHQ-15(r=0.591,P=0.000)and PHQ-12(r=0.574,P=0.000).Anxiety(r=0.469,P=0.000)and depression(r=0.518,P=0.000)were associated with NDI.Somatization measured by adapted PHQ-15(r=0.596,P=0.000),PHQ-15(r=0.584,P=0.000)and PHQ-12(r=0.566,P=0.000)related with NDI.The multiply linear regression analysis showed that somatization measured by adapted PHQ-15(β=0.434,P=0.000)and depression(β=0.217,P=0.000)were determinants of quality of life;somatization measured by PHQ-15(β=0.345,P=0.000)and depression(β=0.267,P=0.000)were determinants of quality of life;somatization measured by PHQ-12(β=0.285,P=0.000)and depression(β=0.284,P=0.000)were determinants of quality of life.Logistic regression analyses showed that NDI,DSS and somatization were the influential factors of conventional therapeutic effect for FD patients,the somatization measured by adapted PHQ-15(OR=1.781,P=0.000),PHQ-15(OR=1.633,P=0.000)and PHQ-12(OR=1.467,P=0.000).Conclusions: The reliability and validity of adapted PHQ-15 might be better than PHQ-15 and PHQ-12.Adapted PHQ-15 could detect more moderate and severe somatization patients,and the correlations with anxiety,depression,NDI might be better than PHQ-15 and PHQ-12.The influence of somatization measured by adapted PHQ-15 on quality of life was more important than anxiety and depression.Somatization was the influential factor of conventional therapeutic effect on FD patients,and the somatization measured by adapted PHQ-15 may be more important than the somatization measured by PHQ-15 and PHQ-12.These results suggest that adapted PHQ-15 may be more suitable for measuring the somatization of FD.