Screening for depression and anxiety disorders has been proposed in prison populations but little is known about caseness thresholds on commonly used self-report measures in relation to core symptoms, risk factors and symptom patterns. A cross-sectional prevalence survey measured depression and anxiety caseness (threshold scores > 10 and > 15 on PHQ-9 and GAD-7 and diagnostic algorithm on PHQ-9) in 1205 male prisoners aged 35–74 years eligible for an NHS Healthcheck from six English prisons. Caseness scores were compared with the presence or absence of daily core symptoms of depression and generalised anxiety disorder (GAD), demographic, prison and cardiovascular risk factors. Cluster analysis was applied to PHQ-9 and GAD-7 items in prisoners scoring > 10 on PHQ-9. 453(37.6%) and 249(20.7%) prisoners scored > 10 and > 15 respectively on PHQ-9; 216 (17.9%) had a depressive episode on the PHQ-9 algorithm; 378(31.4%) and 217(18.0%) scored > 10 and > 15 on GAD-7 respectively. Daily core items for depression were scored in 232(56.2%) and 139(74.3%) prisoners reaching > 10 and > 15 respectively on PHQ-9; daily core anxiety items in 282(74.9%) and 179(96.3%) reaching > 10 and > 15 on GAD-7. Young age, prison and previous high alcohol intake were associated with > 15 on the PHQ-9. Cluster analysis showed a cluster with core symptoms of depression, slowness, restlessness, suicidality, poor concentration, irritability or fear. Altered appetite, poor sleep, lack of energy, guilt or worthlessness belonged to other clusters and may not be indicative of depression. In male prisoners > 35 years, a score of > 10 on the PHQ-9 over diagnoses depressive episodes but a score of > 10 on the GAD-7 may detect cases of GAD more efficiently. Further research utilising standardised psychiatric interviews is required to determine whether the diagnostic algorithm, a higher cut-off on the PHQ-9 or the profile of symptoms on the PHQ-9 and GAD-7 used singly or in combination may be used to screen depressive episodes efficiently in prisoners.

中文翻译：

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在 NHS 健康检查中使用 PHQ-9 和 GAD-7 筛查男性囚犯的抑郁和焦虑：症状模式和病例阈值

已经提议在监狱人群中筛查抑郁症和焦虑症，但对与核心症状、风险因素和症状模式相关的常用自我报告措施的病例阈值知之甚少。一项横断面患病率调查测量了 1205 名 35-74 岁有资格接受 NHS 健康检查的男性囚犯的抑郁和焦虑情况（PHQ-9 和 GAD-7 的阈值得分 > 10 和 > 15，以及 PHQ-9 的诊断算法）。六个英国监狱。案例评分与抑郁症和广泛性焦虑症 (GAD) 的日常核心症状的存在与否、人口统计学、监狱和心血管危险因素进行了比较。在 PHQ-9 上得分 > 10 的囚犯中，将聚类分析应用于 PHQ-9 和 GAD-7 项目。453(37.6%) 和 249(20.7%) 名囚犯得分 > 10 和 > PHQ-9分别有15个；216 (17.9%) 人在 PHQ-9 算法中有抑郁发作；378(31.4%) 和 217(18.0%) 在 GAD-7 上的得分分别 > 10 和 > 15。232 (56.2%) 和 139 (74.3%) 名囚犯分别在 PHQ-9 上评分 > 10 和 > 15；282(74.9%) 和 179(96.3%) 的每日核心焦虑项目在 GAD-7 上达到 > 10 和 > 15。在 PHQ-9 中，年轻、监狱和以前的高酒精摄入量与 > 15 相关。聚类分析显示了一个具有抑郁、迟钝、烦躁、自杀、注意力不集中、易怒或恐惧等核心症状的聚类。食欲改变、睡眠不佳、精力不足、内疚或无价值属于其他集群，可能不是抑郁症的征兆。在 > 35 岁的男性囚犯中，得分 > PHQ-9 上的 10 分可诊断抑郁发作，但 GAD-7 上的分数 > 10 分可以更有效地检测 GAD 病例。需要利用标准化的精神病学访谈进行进一步研究，以确定诊断算法、PHQ-9 的更高临界值或单独或组合使用的 PHQ-9 和 GAD-7 的症状概况是否可用于筛查抑郁症在囚犯中有效地进行情节。