Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan

• Published in: Comprehensive psychiatry Vol. 52; no. 1; pp. 96 - 101
• Main Authors: Liu, Shen-Ing, Yeh, Zai-Ting, Huang, Hui-Chun, Sun, Fang-Ju, Tjung, Jin-Jin, Hwang, Lee-Ching, Shih, Yang-Hsien, Yeh, Andrew Wei-Chiang
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2011; Elsevier Limited
• Subjects: Adult; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - psychology; Female; Humans; Male; Medical research; Mental depression; Mental disorders; Personal Satisfaction; Primary care; Primary Health Care - methods; Psychiatric Status Rating Scales; Psychiatry; Quality of Life - psychology; Reproducibility of Results; Studies; Surveys and Questionnaires - standards; Taiwan; Taiwan
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2010.04.013

Abstract Purpose The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire (PHQ-9) for the purpose of screening major depressive disorder (MDD) among primary care patients in Taiwan. Method A total of 1954 primary care patients completed the PHQ-9. Patients (n = 1532) were interviewed using the Schedule for Clinical Assessments in Neuropsychiatry and 17-item of Hamilton Rating Scale. Subsample cases were retested within 2 weeks. Results The PHQ-9 had a good internal consistency ( α = .80) and test-retest reliability (intraclass correlation coefficient = 0.87). A principal component factor analysis yielded 1-factor structure, which accounted for a total of 42.0% of the variance. The PHQ-9 was significantly correlated with the external validators such as the 17-item of Hamilton Rating Scale and the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire ( P < .001). Using the Schedule for Clinical Assessments in Neuropsychiatry interview as the criterion standard, a PHQ-9 score of 10 or higher had a sensitivity of 0.86 and a specificity of 0.94 for recognizing MDD. The screening accuracy of the 2 items version, PHQ-2, was also satisfactory (scores ≥2: sensitivity 0.88; specificity 0.82). The single-question screen, PHQ-1 (depressed mood), was 78% sensitive and 93% specific for detecting MDD (score ≥2). Conclusion The PHQ-9 and its 2 subscales, PHQ-2 and PHQ-1, seem reliable and valid for detecting MDD among Chinese primary care patients.