Exploring the differences in psychometric properties of commonly used self-rating depression scales across various populations in China: A quantitative systematic review

IF 4.5 4区医学 Q1 PSYCHIATRY

Asian journal of psychiatry Pub Date : 2025-07-24 DOI:10.1016/j.ajp.2025.104635

Yan-Jie Zhao , Ping-Ping Gui , Jin-Jie Xu , Tong Guo , Jing Li , Jing Wang , Gang Wang , Linghui Meng

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引用次数: 0

Abstract

Background

Depression, a mental health condition affecting millions globally, poses significant challenges in clinical diagnosis and treatment due to its unclear pathophysiological mechanism and lack of effective diagnostic biomarkers. While rating scales remain crucial for identifying and evaluating depression, their reliability and validity across diverse populations remain understudied. This study aims to systematically compare the internal consistency reliability and criterion validity of four commonly used self-rating depression scales, the Patient Health Questionnaire-9 (PHQ-9), the Zung Self-Rating Depression Scale (SDS), the Beck Depression Inventory (BDI), and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) in Chinese populations.

Methods

A quantitative systematic review was conducted, encompassing a literature search of Chinese and English medical databases, screening and selection of eligible studies, and data extraction. Internal consistency reliability (Cronbach's α) and criterion validity (correlation coefficients) of each scale were compared across studies and sub-populations. Data analyses were performed using R language version 4.3.1.

Results

A total of 53 studies involving 35,676 participants were included. PHQ-9 was validated in more diverse sub-populations than the other scales. The BDI exhibited the highest overall internal consistency reliability. PHQ-9 and QIDS-SR demonstrated lower internal consistency reliabilities among older adults. BDI had relatively lower Cronbach’s α in female patients with infertility, while SDS had relatively lower Cronbach’s α among patients with liver cirrhosis and women in rural areas. Criterion validities varied across scales, with the most frequently used criterion being the Hamilton Depression Scale-17 (HAMD-17).

Conclusion

This systematic review provides valuable insights into the psychometric properties of commonly used depression scales in Chinese populations. The findings highlight the need for further research on the adaptability of these scales across diverse populations, particularly in older adults and those with specific health conditions.

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探讨中国不同人群常用抑郁自评量表心理测量特性的差异：一项定量系统综述。

背景：抑郁症是一种影响全球数百万人的精神健康状况，由于其病理生理机制尚不清楚，缺乏有效的诊断生物标志物，在临床诊断和治疗中面临着重大挑战。虽然评定量表仍然是识别和评估抑郁症的关键，但它们在不同人群中的可靠性和有效性仍有待研究。本研究旨在系统比较四种常用抑郁自评量表——患者健康问卷-9 （PHQ-9）、Zung抑郁自评量表（SDS）、Beck抑郁量表（BDI）和快速抑郁症状自评量表（QIDS-SR）在中国人群中的内部一致性、信度和效度。方法：进行定量系统评价，包括中文和英文医学数据库的文献检索，筛选和选择符合条件的研究，以及数据提取。比较各量表的内部一致性信度（Cronbach’s α）和标准效度（相关系数）。使用R语言4.3.1版本进行数据分析。结果：共纳入53项研究，涉及35,676名受试者。与其他量表相比，PHQ-9在更多样化的亚群中得到了验证。BDI表现出最高的整体内部一致性信度。PHQ-9和QIDS-SR在老年人中表现出较低的内部一致性信度。女性不孕症患者BDI的Cronbach's α值相对较低，肝硬化患者和农村妇女SDS的Cronbach's α值相对较低。标准的效度因量表而异，最常用的标准是汉密尔顿抑郁量表-17 （HAMD-17）。结论：本系统综述对中国人群常用抑郁量表的心理测量特性提供了有价值的见解。研究结果强调，需要进一步研究这些量表在不同人群中的适应性，特别是在老年人和有特殊健康状况的人群中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian journal of psychiatry Medicine-Psychiatry and Mental Health

CiteScore

12.70

自引率

5.30%

发文量

297

审稿时长

35 days

期刊介绍： The Asian Journal of Psychiatry serves as a comprehensive resource for psychiatrists, mental health clinicians, neurologists, physicians, mental health students, and policymakers. Its goal is to facilitate the exchange of research findings and clinical practices between Asia and the global community. The journal focuses on psychiatric research relevant to Asia, covering preclinical, clinical, service system, and policy development topics. It also highlights the socio-cultural diversity of the region in relation to mental health.