The Development Of PHQ-8 Simplified Scale In Functional Dyspepisa Patients And Its Clinical Application

Objective:To adapt the insufficiency of Somatic Symptom Scale-8?SSS-8?measure somatization in functional dyspepsia patients,investigate the reliability and validity of the questionnaire and evaluate the clinical application effects.Methods:612 FD patients completed the initial SSS-8,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?,and 8 items were selected to constitute the item pool of the PHQ-8.Reliability analysis and validity analysis were carried for PHQ-8 and SSS-8.To explore the relation between anxiety,depression,somatization and quality of life.To observe the conventional therapeutic effect after 4 weeks,study the influential factors for FD,and curative effects for FD patients were compared.Results:The Cronbach's?coefficient of PHQ-8,SSS-8,PHQ-15 and PHQ-12 were 0.601,0.553,0.601 and 0.620,respectively.The correlation coefficients of the total scores of the developed PHQ-8,SSS-8,PHQ-15 and PHQ-12 were?r=0.835,0.739,0.806,P=0.000?,respectively.The correlation coefficients of the total scores of the SSS-8,PHQ-15 and PHQ-12 were?r=0.919,0.924,P=0.000?,respectively.Three factors were extracted of developed PHQ-8 cumulative contribution was 55.103%,three factors were extracted of SSS-8 cumulative contribution was 51.666%.The results of three-factor model showed?²=31.247,RMR=0.01,RMSEA=0.042,GFI=0.984 of developed PHQ-8;?²=17.251,RMR=0.010,RMSEA=0.007,GFI=0.991 of SSS-8.Anxiety was associated with somatization measured by PHQ-8?r=0.318,P=0.000?,developed PHQ-8_?2??level 5 rating of the PHQ-8??r=0.310,P=0.000?and SSS-8?r=0.331,P=0.000?;depression was associated with somatization measured by developed PHQ-8?r=0.442,P=0.000?,developed PHQ-8_?2??r=0.421,P=0.000?and SSS-8?r=0.422,P=0.000?;somatization measured by PHQ-8?r=0.374,P=0.000?,PHQ-8_?2??r=0.351,P=0.000?and SSS-8?r=0.399,P=0.000?related with DSS.Somatization measured by PHQ-8?r=0.404,P=0.000?,PHQ-8_?2??r=0.388,P=0.000?and SSS-8?r=0.389,P=0.000?related with NDI.The multiply linear regression analysis showed that somatization measured by PHQ-8??=0.256,P=0.000?and depression??=0.176,P=0.000?were determinants of DSS;somatization measured by PHQ-8_?2???=0.228,P=0.000?and depression??=0.193,P=0.000?were determinants of DSS;somatization measured by SSS-8??=0.257,P=0.000?and depression??=0.188,P=0.000?were determinants of DSS.Logistic regression analyses showed that NDI and somatization were the influential factors of conventional therapeutic effect for FD patients,the somatization measured by PHQ-8?OR=1.781,P=0.000?,PHQ-8_?2??OR=1.633,P=0.000?and SSS-8?OR=1.467,P=0.000?.The multiply linear regression analysis showed that somatization measured by PHQ-8??=0.270,P=0.000?,anxiety??=0.163,P=0.000?and depression??=0.136,P=0.003?were determinants of NDI;somatization measured by PHQ-8_?2???=0.250,P=0.000?,anxiety??=0.164,P=0.000?and depression??=0.150,P=0.001?were determinants of NDI;somatization measured by SSS-8??=0.250,P=0.000?,anxiety??=0.156,P=0.000?and depression??=0.155,P=0.001?were determinants of NDI;Logistic regression analysis showed that PHQ-8,PHQ-8_?2?and the SSS-8 assessment of somatization?OR=1.131,1.082,1.072,P=0.000?were the effects of conventional treatment of FD patients.The ROC curve prediction results of the improvement of symptoms by 75%as the treatment effect demarcation point,PHQ-8,PHQ-8_?2?and SSS-8 were:0.645,0.646,0.632.Conclusion:The developed PHQ-8 simplified scale and SSS-8 have a good reliability and validity,the developed PHQ-8 simplified scale is better than SSS-8 compared with PHQ-12 which removes gastrointestinal symptoms,the somatization of PHQ-8 simplified scale may have a greater impact on the quality of life of FD patients than that of SSS-8.There is no difference in the efficacy between PHQ-8 simplified scale and SSS-8simplified scale,which suggests that PHQ-8 simplified scale may be more effective in evaluating the somatization of FD patients instead of SSS-8.These results may be helpful in the further development of a better somatic symptom scale in FD.