Performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care.

OBJECTIVE: To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS: Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subjects (n = 284; male = 107, female = 177) had to return the questionnaires to their health care professional within 48 hours and undergo a diagnostic evaluation interview based on the Japanese version of M.I.N.I-Plus. RESULTS: 93 patients were diagnosed as having major depressive disorder (MDD). In the J-PHQ-9, the optimal cutpoint ≥ 10 had sensitivity of 90.5% and specificity of 76.6%. As for the categorical algorithms, the sensitivity was 80.6%; specificity was 89.5%, and a positive likelihood ratio of 7.7. The Stratum-specific likelihood ratios (SSLRs) of the J-PHQ-9 scores of 0-9, 10-14, 15-19, and 20-27 for major depression were 0.10 (95% CI: 0.05-0.20), 1.67 (95% CI: 1.02-2.76), 5.41 (95% CI: 2.87-10.22), and 11.98 (95% CI: 5.39-26.63), respectively. The relationship between the severity of J-PHQ-9 and the MCS of SF-8 was significant (χ 2 ＝ 85.72, df = 4, P ≤ 0.0001). CONCLUSIONS: This study has validated the J-PHQ-9 as a useful tool for the assessment of MDD in primary care in Japan.

A Cluster Analysis of Bronchial Asthma Patients with Depressive Symptoms.

Objective Whether or not depression affects the control or severity of asthma is unclear. We performed a cluster analysis of asthma patients with depressive symptoms to clarify their characteristics. Methods Multiple medical institutions in Niigata Prefecture, Japan, were surveyed in 2014. We recorded the age, disease duration, body mass index (BMI), medications, and surveyed asthma control status and severity, as well as depressive symptoms and adherence to treatment using questionnaires. A hierarchical cluster analysis was performed on the group of patients assessed as having depression. Results Of 2,273 patients, 128 were assessed as being positive for depressive symptoms [DS(+)]. Thirty-three were excluded because of missing data, and the remaining 95 DS[+] patients were classified into 3 clusters (A, B, and C). The patients in cluster A (n=19) were elderly, had severe, poorly controlled asthma, and demonstrated possible adherence barriers; those in cluster B (n=26) were elderly with a low BMI and had no significant adherence barriers but had severe, poorly controlled asthma; and those in cluster C (n=50) were younger, with a high BMI, no significant adherence barriers, well-controlled asthma, and few were severely affected. The scores for depressive symptoms were not significantly different between clusters. Conclusion About half of the patients in the DS[+] group had severe, poorly controlled asthma, and these clusters were able to be distinguished by their Adherence Starts with Knowledge (ASK)-12 score, which reflects adherence barriers. The control status and severity of asthma may also be related to the age, disease duration, and BMI in the DS[+] group.

Electrogastrographic responses to the stress of a mirror drawing test in outpatients consulting a psychosomatic clinic.

The respiratory rate, LF, HF, and the LF/HF ratio from heart rate variability (HRV) were compared between outpatients (n=25) and controls (n=58) during rest and while performing a mirror drawing test (MDT). Anxiety and depression scores were obtained before the test. In addition, the power content of the electrogastrograms (EGGs) recorded during MDT were compared to those recorded during rest (c-MDT/r). The anxiety scores, depression scores, resting heart rate, resting respiratory rate and the 3 cpm resting frequency of the epigastric EGG were significantly higher in outpatients than in controls. Both the heart rate and the 3 cpm frequency in the infraumbilical EGG during the stress of the MDT were significantly higher in outpatients than in controls. Instability factors (IF, standard deviation/mean frequency) of the 3 cpm frequency in the epigastric EGG were higher in controls than in outpatients, though the spectral frequencies were similar and insignificantly different between the two groups. Interestingly, the slope of the significant linear correlation was positive in controls but was negative in outpatients between both the resting LF/HF and the power content ratio of the 3 cpm frequency in the infraumbilical EGG, c-MDT/r, which corresponds to the colonic responses to MDT stress.