Validity and reliability of Patient Health Questionnaire-9 and Patient Health Questionnaire-2 to screen for depression among college students in China

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Abstract

This study examined the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-2 (PHQ-2). The optimal cutoff score when screening for depression among Chinese college students was also determined.

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The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review.

Kurt Kroenke, Robert L Spitzer, Janet B W Williams … (2010)

Depression, anxiety and somatization are the most common mental disorders in primary care as well as medical specialty populations; each is present in at least 5-10% of patients and frequently comorbid with one another. An efficient means for measuring and monitoring all three conditions would be desirable. Evidence regarding the psychometric and pragmatic characteristics of the Patient Health Questionnaire (PHQ)-9 depression, generalized anxiety disorder (GAD)-7 anxiety and PHQ-15 somatic symptom scales are synthesized from two sources: (1) four multisite cross-sectional studies (three conducted in primary care and one in obstetric-gynecology practices) comprising 9740 patients, and (2) key studies from the literature that have studied these scales. The PHQ-9 and its abbreviated eight-item (PHQ-8) and two-item (PHQ-2) versions have good sensitivity and specificity for detecting depressive disorders. Likewise, the GAD-7 and its abbreviated two-item (GAD-2) version have good operating characteristics for detecting generalized anxiety, panic, social anxiety and post-traumatic stress disorder. The optimal cutpoint is > or = 10 on the parent scales (PHQ-9 and GAD-7) and > or = 3 on the ultra-brief versions (PHQ-2 and GAD-2). The PHQ-15 is equal or superior to other brief measures for assessing somatic symptoms and screening for somatoform disorders. Cutpoints of 5, 10 and 15 represent mild, moderate and severe symptom levels on all three scales. Sensitivity to change is well-established for the PHQ-9 and emerging albeit not yet definitive for the GAD-7 and PHQ-15. The PHQ-9, GAD-7 and PHQ-15 are brief well-validated measures for detecting and monitoring depression, anxiety and somatization. Copyright 2010. Published by Elsevier Inc.

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Social support and mental health among college students.

Jennifer Hefner, Daniel Eisenberg (2009)

This study is the first, to our knowledge, to evaluate the relationship between mental health and social support in a large, random sample of college students. A Web-based survey was administered at a large, public university, with 1,378 students completing the measures in this analysis (response rate = 57%). The results support our hypothesis that students with characteristics differing from most other students, such as minority race or ethnicity, international status, and low socioeconomic status, are at greater risk of social isolation. In addition, the authors found that students with lower quality social support, as measured by the Multidimensional Scale of Perceived Social Support, were more likely to experience mental health problems, including a sixfold risk of depressive symptoms relative to students with high quality social support. These results may help administrators and health providers to identify more effectively the population of students at high risk for mental illness and develop effective interventions to address this significant and growing public health issue. (c) 2009 APA, all rights reserved.

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The Patient Health Questionnaire-9 for measuring depressive symptoms among the general population in Hong Kong.

Xiaonan Yu, Wilson W. S. Tam, Paul Wong … (2012)

The Patient Health Questionnaire-9 (PHQ-9) assesses depressive symptoms by self-report, is brief, and was developed to correspond to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for major depression. This article presents information regarding its reliability and validity and the distribution of scores in a Chinese community sample in Hong Kong. A total of 6028 participants 15 years or older were recruited using random household sampling. They completed the Chinese version of the PHQ-9, the Happiness Scale, the Chinese Health Questionnaire, and the Short-Form 12-Item Health Survey (SF-12). Information was also gathered on health and health service use. Exploratory factor analysis and confirmatory factor analysis supported a single factor with strong loadings for all 9 items. Multiple-group analyses demonstrated that the structure can be generalized across sex and age groups (ie, adolescents, adults, and individuals 65 years or older). The internal consistency of the PHQ-9 was 0.82. The test-retest reliability over a 2-week interval was 0.76. As expected, the total score of the PHQ-9 was significantly associated with the Chinese Health Questionnaire (r = 0.49) and the Happiness Scale (r = -0.41). In addition, as expected, the relationship with the physical component subscale of the SF-12 was significantly weaker (r = -0.27) than for the mental component subscale of the SF-12 (r = -0.60). Participants with higher scores on the PHQ-9 were more likely to report having been diagnosed with depression by a physician, having chronic illness, using medicine, and using inpatient and outpatient health services. Almost 40% of participants did not report any depressive symptoms (score, 0). Self-reported symptoms at a level that would qualify for a diagnosis of major depressive disorder were provided by 1.7% of the participants. Our data support the reliability and validity of the PHQ-9 in assessing depressive symptoms among the general population in Hong Kong. Its validity against diagnostic interview for major depressive disorder and its sensitivity and specificity should be determined in future studies. Copyright © 2012 Elsevier Inc. All rights reserved.