Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians? diagnoses

Löwe, Bernd; Spitzer, Robert L.; Gräfe, Kerstin A.; Kroenke, Kurt; Quenter, Andrea; Zipfel, Stephan; Buchholz, Christine; Witte, Steffen; Herzog, Wolfgang

doi:10.1016/s0165-0327(02)00237-9

Cited by 887 publications

(700 citation statements)

References 46 publications

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“…[19][20][21] The sensitivity and specificity of the PHQ-9 for identifying a probable case of minor depression compared to structured psychiatric interview has been shown to be 77 % and 86 %, respectively. 22 Importantly, the PHQ-9 has been validated in patients with diabetes. 23,24 Covariates of Interest…”

Section: Primary Independent Variablementioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

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BACKGROUND: Hospitalizations for ambulatory caresensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate ambulatory care is provided, may be an important contributor to rising healthcare costs and public health burden. OBJECTIVE: To examine if probable major depression is independently associated with hospitalization for an ACSC in patients with diabetes. DESIGN: Secondary analysis of data from a prospective cohort study. PARTICIPANTS: Population-based cohort of 4,128 patients with diabetes ≥ 18 years old seen in primary care, who were enrolled between 2000 and 2002 and followed for 5 years (through 2007). MAIN MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire-9. Outcomes of interest included time to initial hospitalization for an ACSC and total number of ACSC-related hospitalizations. We used Cox proportional hazards regression models to ascertain an association between probable major depression and time to ACSC-related hospitalization, as well as Poisson regression for models examining probable major depression and number of ACSC-related hospitalizations. KEY RESULTS: Patients' mean age at study enrollment was 63.4 years (Standard Deviation: 13.4 years). Over the 5-year follow-up period, 981 patients in the study were hospitalized a total of 1,721 times for an ACSC, comprising 45.1 % of all hospitalizations. After adjusting for baseline demographic, clinical and health-risk behavioral factors, probable major depression was associated with initial ACSC-related hospitalization (Hazard Ratio: 1.41, 95 % Confidence Interval [95 % CI]: 1.15, 1.72) and number of ACSC-related hospitalizations (Relative Risk: 1.37, 95 % CI: 1.12, 1.68). CONCLUSIONS: Probable major depression in patients with diabetes is independently associated with hospitalization for an ACSC. Additional research is warranted to ascertain if effective interventions for depression in patients with diabetes could reduce the risk of hospitalizations for ACSCs and their associated adverse outcomes.

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Section: Primary Independent Variablementioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

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“…Low scores are taken to reflect possible depression and poorer quality of life. A cut-off range of 7-9 is recommended as appropriate for detecting any depressive disorder 39 . It is recommended to administer the Major Depression (ICD-10) Inventory or another depression diagnostic scale if the raw score is below 13 or if the patient has answered 0 or 1 to any of the five items.…”

Section: Who-five Well-being Indexmentioning

confidence: 99%

“…Psychometrically, Lowe et al 41 give the figures for sensitivity, specificity and overall accuracy for variations in cut-off point for major depressive disorders, and demonstrate high internal consistency (Cronbach's alpha of 0.91).…”

Section: Who-five Well-being Indexmentioning

confidence: 99%

The distribution of wellbeing in Ireland

Delaney

Doyle

McKenzie

et al. 2009

Ir. j. psychol. Med.

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Objectives: There is a substantial knowledge gap about the distribution of mental heath in community populations. The European Social Survey is particularly useful as it contains information on over 40,000 individuals, including 2,286 Irish adults. The objective of this study is to conduct a large scale statistical analysis to examine the distribution and determinants of mental well-being in a large representative sample of the Irish population.Method: Analysis of the European Social Survey using robust multiple linear and non-linear regression techniques. The data-set contains WHO-5 scores and subjective well-being for a sample of 2,286 Irish people interviewed in their homes in 2005.Results: Ireland has the second highest average WHO-5 score among the 22 countries in the European Social Survey. Multiple linear regression analysis across the distribution of WHO-5 reveals a well-being gradient largely related to education and social capital variables. A probit model examining the determinants of vulnerability to psychiatric morbidity reveals that a similar set of factors predict scores below the threshold point on the WHO-5 scale. Conclusions:The results are consistent with marked differences in mental well-being across education levels and variables relating to social capital factors. Such indicators provide a useful index for policy-makers and researchers. However, much further work is needed to identify causal mechanisms generating observed differences in mental health across different socioeconomic groups.

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“…The PHQ-9 has been validated in western countries regarding construct validity 53,54,57,[59][60][61][62][63][64] , diagnostic accuracy 53,57,58,62,[64][65][66][67][68] , sensitivity to change 61,69,70 , responsiveness to treatment [71][72][73] , internal consistency 56,57,63,65,74,75 , test-retest reliability 56,57,62,73 and realistic estimates of population base rates 74 . The PHQ-2 (i.e., the first two items of the PHQ-9) is an ultra-brief and accurate screening tool 58,[76][77][78] .…”

Section: Introductionmentioning

confidence: 99%

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

et al. 2008

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BACKGROUND: Depression greatly burdens subSaharan Africa, especially populations living with HIV/ AIDS, for whom few validated depression scales exist. Patient Health Questionnaire-9 (PHQ-9), a brief dualpurpose instrument yielding DSM-IV diagnoses and severity, and PHQ-2, an ultra-brief screening tool, offer advantages in resource-constrained settings. OBJECTIVE:To assess the validity/reliability of PHQ-9 and PHQ-2. DESIGN: Observational, two occasions 7 days apart.PARTICIPANTS: A total of 347 patients attending psychosocial support groups.MEASUREMENTS: Demographics, PHQ-9, PHQ-2, general health perception rating and CD4 count. RESULTS:Rates for PHQ-9 DSM-IV major depressive disorder (MDD), other depressive disorder (ODD) and any depressive disorder were 13%, 21% and 34%. Depression was associated with female gender, but not CD4. Construct validity was supported by: (1) a strong association between PHQ-9 and general health rating, (2) a single major factor with loadings exceeding 0.50, (3) item-total correlations exceeding 0.37 and (4) a pattern of item means similar to US validation studies. Four focus groups indicated culturally relevant content validity and minor modifications to the PHQ-9 instructions. Coefficient alpha was 0.78. Test-retest reliability was acceptable: (1) intraclass correlation 0.59 for PHQ-9 total score, (2) kappas 0.24, 0.25 and 0.38 for PHQ-9 MDD, ODD and any depressive disorder and (3) weighted kappa 0.53 for PHQ-9 depression severity categories. PHQ-2 ≥3 demonstrated high sensitivity (85%) and specificity (95%) for diagnosing any PHQ-9 depressive disorder (AUC, 0.97), and 91% and 77%, respectively, for diagnosing PHQ-9 MDD (AUC, 0.91). Psychometrics were also good within four gender/age (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) subgroups.CONCLUSIONS: PHQ-9 and PHQ-2 appear valid/ reliable for assessing DSM-IV depressive disorders and depression severity among adults living with HIV/AIDS in western Kenya. INTRODUCTIONMore than 70% of all deaths attributable to HIV/AIDS are in sub-Saharan Africa, with approximately 6.1% of adults living with HIV in Kenya in 2005 1 . The social, economic and health impact of depression in sub-Saharan Africa is also great, where depression is associated with mortality 2-5 , work disability 4-7 , lower quality of life 5,[8][9][10][11][12] , risk of heart disease 13 and high-risk behaviors for contracting HIV infection 14 . With one exception 15 , the sparse literature on depression among individuals living with HIV/AIDS in sub-Saharan Africa has shown elevated rates of depression relative to community samples 3,8,10,[16][17][18][19][20][21][22][23][24][25] , consistent with western countries [26][27][28][29] . Thus, there is an urgency to incorporating mental health into HIV/ AIDS treatment programs in sub-Saharan Africa, including western Kenya [30][31][32][33][34][35] .Depression in sub-Saharan Africa presents in forms (culturespecific idioms, somatic, based on interpersonal relationships or spiritual in nature) that may o...

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Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians? diagnoses

Cited by 887 publications

References 46 publications

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

The distribution of wellbeing in Ireland

Validity/Reliability of PHQ-9 and PHQ-2 Depression Scales Among Adults Living with HIV/AIDS in Western Kenya

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