Diagnostic accuracy, internal consistency, and convergent validity of the Greek version of the patient health questionnaire 9 in diagnosing depression in rheumatologic disorders

Abstract

Objective. The Patient Health Questionnaire 9 (PHQ-9) was developed to screen for depressive disorders in community, primary care, and medical settings. We aimed to estimate its diagnostic accuracy, internal consistency, reliability, and convergent validity in diagnosing major depressive disorder (MDD) in Greek patients with rheumatologic disorders. Methods. In a 2-phase sampling design study, we recruited 475 patients with established rheumatologic disorders. One of 2 of the high scorers (PHQ-9 score >9, n ‫؍‬ 85) and 1 of 3 of the low scorers (PHQ-9 score 0 -8, n ‫؍‬ 128) were interviewed using the Mini International Neuropsychiatric Interview to confirm MDD. A receiver operator characteristic curve analysis was performed to confirm the optimum threshold value. The scale's dimensional structure was tested with factor analysis, and internal consistency reliability was assessed with Cronbach's alpha. Psychological distress (Symptom Check List-90-Revised [SCL-90-R]), disability (Health Assessment Questionnaire disability index), and health-related quality of life (HRQOL; World Health Organization Quality of Life Instrument [WHOQOL-BREF]) were also assessed to test convergent validity with bivariate correlations.Results. At an optimum threshold of 10, the PHQ-9 showed a sensitivity of 81.2% and a specificity of 86.8%. The area under the curve was 0.91. The PHQ-9 presented unidimensional structure with good scale reliability (␣ ‫؍‬ 0.82). The PHQ-9 score presented the greatest correlations with SCL-90-R depression (r ‫؍‬ 0.736) and WHOQOL-BREF mental HRQOL scales (r ‫؍‬ ؊0.571), and all other correlations with disability and HRQOL were in the expected direction. Conclusion. At a cutoff of 10, the PHQ-9 is an accurate, reliable, and valid measure for screening for MDD among Greek rheumatologic patients.

The Greek Version of the Sense of Coherence Scale (SOC-29): Psychometric Properties and Associations with Mental Illness, Suicidal Risk and Quality of Life

“…Higher scores indicate more severe symptoms. It has been translated into numerous languages including Greek and is considered a valid measure of depressive symptom severity [22,25]. Cronbach's alpha for PHQ-9 derived from the present sample was 0.83.…”

“…Depressive symptom severity was assessed using the validated Greek version of the Patient Health Questionnaire-9 (PHQ-9) [22,24]. This instrument screens for DSM-IV major depressive disorder.…”

“…Being fully structured to allow administration by clinicians after a brief training session, it was designed to meet the need for a short but valid psychiatric interview for epidemiology studies [21]. MINI has been previously used in studies with Greek medical patients [22,23].…”

Anxiety and depressive symptoms and illness perceptions in psoriatic arthritis and associations with physical health‐related quality of life

“…The PHQ-9 yields an index of depressive symptom severity, with scores of 1-4 indicating no depression, 5-9 indicating mild depression, 10 -14 indicating moderate depression, 15-19 indicating moderately severe depression, and 20 -27 indicating severe depression (20). We have recently shown that, at a threshold of a score of Ն10, the PHQ-9 showed a sensitivity of 81.2% and a specificity of 86.8% in diagnosing MDD among Greek patients with rheumatic disease (33). Therefore, in the present study, we used this PHQ-9 cutoff score to define patients with moderate to severe depressive symptoms.…”

The Greek Version of the Resilience Scale (RS-14): Psychometric Properties in three Samples and Associations with Mental Illness, Suicidality, and Quality of Life

“…Being fully structured to allow administration by clinicians after a brief training session, it was designed to meet the need for a short but valid psychiatric interview for epidemiology studies [41]. MINI has been previously used in studies with Greek medical patients [42,43].…”