世界卫生组织五项身心健康指标在识别高中生抑郁障碍中的信效度
doi:10.3969/j.issn.1000-6729.2011.04.010
（中国心理卫生杂志，2011，25（4）：279-283.）
Reliability and validity of the World Health Organization Five-item Well-Being Index for
detecting depressive disorders in senior middle school students
WANG Zhou?1,BIAN Qian?2
?1Changzhou De An Hospital,Changzhou 213003,Jiangsu province,China.省略
【】 Objective:To examine the reliability and validity of the World Health Organization Five-item Well-Being Index （WHO-5） for detecting depressive disorders in senior middle school students.Methods:A sample of 706 grade 1 to grade 3 students from one senior middle school in Shanghai completed the WHO-5.Cronbach' s alpha coeffiicient and structure validity were
examined.Structure validity was evaluated using factor analysis.The Beck Depression Inventory (BDI) was used to explore the correlative validity.Totally 104 students were
readministered the WHO-5 2 weeks after its initial administration to assess the test-retest reliability.And 134 students were also interviewed by psychiatrists to assess whether they had any depressive disorders according to Mini International Neuropsychiatry Inventory (MINI).MINI was regarded as the gold standard to investigate the validity of WHO-5.Criterion-related validity was evaluated using receiver operating characteristic ROC analysis.Results:The Cronbach' s alpha was estimated to be 0.907.the test-retest reliability was 0.644.A factor analysis identified only one factor.The WHO-5 was significantly correlated with BDI.Correlative validity was -0.52.ROC analysis showed that the WHO-5 could be used to detect depressive disorders (area under curve:0.714).A cut-off of 11.5 or 12.5 yielded the balanced sensitivity/specificity trade-off:70%/62% or
85%/56%.Conclusion:The World Health Organization
Five-item Well-Being Index （WHO-5） has an adequate internal consistency.The WHO-5 demonstrates good sensitivity and common specificity.It may be a
coarse-screen instrument for detecting depressive disorders in senior middle school students.
（Chin Ment Health J,2011,25(4):279-283）世界卫生组织（WHO）、世界银行和美国哈佛公共卫生学院在1993年开展的一项全球疾病负担（Global Burden of Disease，GBD）合作研究显示，1990年抑郁症在全球疾病负担排序第5位，到2020年，抑郁症将成为继冠心病后的第2大疾病负担源；而抑郁症也是中国精神疾病负担中的最主要问题（1990年为精神疾病负担的44%，预测2020年为47%）［1］。青少年抑郁问题按照程度及范围分为抑郁情绪、抑郁症状、抑郁障碍3个层次［2］，国内外报道青少年抑郁问题发生率高达25%~44%［3-4］，而高中阶段是青少年人格完善和定型的重要时期，这一阶段学业负担、家庭冲突及人际关系的变化较多较快，所以各种心理问题特别是抑郁出现较多。抑郁可显著影响个体的心身健康、社会交往、学习工作能力，严重者导致自杀，给家庭和社会带来巨大损失，因此早期识别高中生抑郁显得尤为重要。
目前有很多量表可以识别青少年抑郁，其中多数量表结构相对复杂或者需要专业人员进行评定［5］；世界卫生组织五项身心健康指标(World Health Organization Five-item Well-Being Index,WHO-5)具有如下优点：结构简短，由测试者自我评定，使用方便，而且问卷内容积极健康不会给测试者尤其是抑郁患者带来心理阴影［6-7］。WHO-5最初的版本有28题项，主要用于检测糖尿病病人的抑郁问题，后几经删减形成目前的5题项版本［8-12］。目前版本的WHO-5不但可用于糖尿病病人也可用于非
