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Chinese version of the Perceived Stress Scale-10: A psychometric study in Chinese university students

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      Abstract

      Chinese university students often suffer from acute stress, which can affect their mental health. We measured and evaluated perceived stress in this population using the Simplified Chinese version of the 10-item Perceived Stress Scale (SCPSS-10). The SCPSS-10, Patient Health Questionnaire (PHQ), and Generalized Anxiety Disorder 7-item scale (GAD-7) were conducted in 1096 university students. Two weeks later, 129 participants were re-tested using the SCPSS-10. Exploratory factor analysis yielded two factors with Eigen values of 4.76 and 1.48, accounting for 62.41% of the variance. Confirmatory factor analysis demonstrated good fit of this two-factor model. The internal consistency reliability, as measured by Cronbach’s α, was 0.85. The test-retest reliability coefficient was 0.7. The SCPSS-10 exhibited high correlation with the PHQ-9 and GAD-7, indicating an acceptable concurrent validity. The SCPSS-10 exhibited satisfactory psychometric properties in Chinese university students.

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      The PHQ-9: validity of a brief depression severity measure.

      While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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        A global measure of perceived stress.

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          Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire.

          The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness. To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD. Criterion standard study undertaken between May 1997 and November 1998. Eight primary care clinics in the United States. Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ. Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions. A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized. Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.
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            Author and article information

            Affiliations
            [1 ] Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
            [2 ] Academic Affairs Office, Shanghai Jiao Tong University, Shanghai, P.R. China
            Xi′an Jiaotong University School of Medicine, CHINA
            Author notes

            Competing Interests: The authors have declared that no competing interests exist.

            Contributors
            Role: Conceptualization, Role: Data curation, Role: Formal analysis, Role: Investigation, Role: Methodology, Role: Writing – original draft, Role: Writing – review & editing
            Role: Conceptualization, Role: Data curation, Role: Formal analysis, Role: Investigation, Role: Methodology, Role: Project administration, Role: Validation
            Role: Formal analysis, Role: Resources, Role: Visualization
            Role: Data curation, Role: Formal analysis, Role: Investigation, Role: Methodology, Role: Project administration, Role: Resources, Role: Validation, Role: Visualization
            Role: Conceptualization, Role: Resources, Role: Writing – original draft, Role: Writing – review & editing
            ORCID: http://orcid.org/0000-0001-8382-3050, Role: Conceptualization, Role: Formal analysis, Role: Project administration, Role: Visualization, Role: Writing – original draft, Role: Writing – review & editing
            Role: Editor
            Journal
            PLoS One
            PLoS ONE
            plos
            plosone
            PLoS ONE
            Public Library of Science (San Francisco, CA USA )
            1932-6203
            18 December 2017
            2017
            : 12
            : 12
            29252989
            5734731
            10.1371/journal.pone.0189543
            PONE-D-17-27628
            (Editor)
            © 2017 Lu et al

            This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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            Figures: 0, Tables: 3, Pages: 8
            Product
            Funding
            Funded by: the Ministry of Science and Technology Project
            Award ID: 2009BAI77B08
            Award Recipient : ORCID: http://orcid.org/0000-0001-8382-3050
            Funded by: Shanghai One Hundred Talent Project in health division
            Award ID: XBR2011015
            Award Recipient :
            Funded by: funder-id http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
            Award ID: 81371486
            Award Recipient :
            This study was supported by the Ministry of Science and Technology Project (2009BAI77B08), Shanghai One Hundred Talent Project in health division (XBR2011015), and the National Natural Science Foundation of China (81371486).
            Categories
            Research Article
            Medicine and Health Sciences
            Mental Health and Psychiatry
            Psychological Stress
            Biology and Life Sciences
            Psychology
            Psychological Stress
            Social Sciences
            Psychology
            Psychological Stress
            Medicine and Health Sciences
            Mental Health and Psychiatry
            Mood Disorders
            Depression
            Biology and Life Sciences
            Psychology
            Psychometrics
            Social Sciences
            Psychology
            Psychometrics
            Biology and Life Sciences
            Psychology
            Emotions
            Anxiety
            Social Sciences
            Psychology
            Emotions
            Anxiety
            Research and Analysis Methods
            Mathematical and Statistical Techniques
            Statistical Methods
            Factor Analysis
            Physical Sciences
            Mathematics
            Statistics (Mathematics)
            Statistical Methods
            Factor Analysis
            Medicine and Health Sciences
            Mental Health and Psychiatry
            Neuropsychiatric Disorders
            Anxiety Disorders
            Medicine and Health Sciences
            Mental Health and Psychiatry
            Neuroses
            Anxiety Disorders
            Research and Analysis Methods
            Research Assessment
            Research Validity
            Medicine and Health Sciences
            Mental Health and Psychiatry
            Custom metadata
            All relevant data are within the paper and its Supporting Information files.

            Uncategorized

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