Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials

Kroenke, Kurt; Wu, Jingwei; Yu, Zhangsheng; Bair, Matthew J.; Kean, Jacob; Stump, Timothy E.; Monahan, Patrick O.

doi:10.1097/psy.0000000000000322

Cited by 331 publications

(355 citation statements)

References 79 publications

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“…The PHQ-9 might well be preferred for its relative brevity. If researchers and clinicians wish to have a broader measure of distress, then the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) [20] (which a composite measure of depression and anxiety symptoms using the Patient Health Questionnaire-9 and Generalised Anxiety Disorder Scale [21]) is recommended [11].…”

Section: Discussionmentioning

confidence: 99%

Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors

Chilcot

Almond

Guirguis

et al. 2018

General Hospital Psychiatry

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Section: Discussionmentioning

confidence: 99%

Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors

Chilcot

Almond

Guirguis

et al. 2018

General Hospital Psychiatry

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“…In most studies, they were considered to be independent and unidimensional instruments (for a review, see [10]), with few studies showing an extra somatic subdimension besides the cognitive affective subdimension in both PHQ-9 and GAD-7 (e.g., [31]). Recently, Kroenke et al [32] combined the PHQ-9 and GAD-7 items and with the use of bifactorial modeling proposed a composite measure of depression and anxiety called the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). According to the bifactorial modelling terminology, PHQ-ADS is the general factor and the two PHQ-9 and GAD-7 scales are the subfactors.…”

Section: Introductionmentioning

confidence: 99%

“…According to the bifactorial modelling terminology, PHQ-ADS is the general factor and the two PHQ-9 and GAD-7 scales are the subfactors. Despite the negligible contribution from the subfactors to the explanation of scale variance, Kroenke et al [32] stated that PHQ-ADS does not override the value of individual PHQ-9 and GAD-7 subfactors. However, they did not provide the evidence showing the independent effect of PHQ-9 and GAD-7 over and above PHQ-ADS.…”

Section: Introductionmentioning

confidence: 99%

Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury

Teymoori

Gorbunova

Haghish

et al. 2020

JCM

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Background: The dimensionality of depression and anxiety instruments have recently been a source of controversy. Objectives and Design: In a European-wide sample of patients after Traumatic Brain Injury (TBI), we aim to examine the factorial structure, validity, and association of the Patient Health Questionnaire for depression (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) instruments. This study is based on longitudinal observational data. We conducted analyses of factorial structure and discriminant validity of outcomes six-months after TBI. We also examined the prevalence, co-occurrence, and changes of scores on the PHQ-9 and GAD-7 at 3-, 6-, and 12-month post-TBI assessments. Participants: At six-months post-TBI assessment, 2137 (738 (34.5%) women) participants completed the PHQ-9 and GAD-7 questionnaires. For the longitudinal analysis, we had 1922 participants (672 (35.0%) women). Results: The results of exploratory factor analysis suggested a general latent construct underlying both PHQ-9 and GAD-7 measures. Confirmatory factor analyses showed a slight improvement in the fit indices for the bifactorial model. The Omega hierarchical test clearly differentiated two subfactors of PHQ-9 and GAD-7 items over and above the underlying general factor; however, most of the variance (85.0%) was explained by the general factor and the explained variance of the subfactors was small. The PHQ-9 and GAD-7 performed similarly in detecting post-traumatic stress disorder (PTSD). As defined by conventional cut-offs, depression and anxiety have different prevalence rates in the sample. The scales also differed in their relationships with the short form of health survey (SF-36v2) subscales. The longitudinal analysis showed high stability of depression and anxiety symptoms: 49–67% of the post-TBI patients with comorbid depression and anxiety reported the persistence of the symptoms over time. Discussion: The factorial structure analysis favors a general latent construct underlying both depression and anxiety scales among patients after TBI. We discuss the implications our findings and future research directions.

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“…In this study, depression did not significantly improve in the overall cancer sample when evaluated using the PHQ-9. However, a sub-analysis which excluded actively dying patients showed a significant and clinically important difference [32] of 7.6 (95% CI = [2.9-12.2]) after 9 weeks of treatment. The quality of sleep was evaluated using the Pittsburgh Sleep Quality Index (PSQI) [33].…”

Section: Evidence From Non-randomised Controlled Trialsmentioning

confidence: 98%

What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review

Economos

Lovell

Johnston

et al. 2019

Support Care Cancer

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Purpose Cancer patients often experience multiple distressing symptoms which are challenging to manage. It would therefore be helpful to find a treatment that alleviates more than one symptom, to avoid polypharmacy: mirtazapine has been used in several studies for this purpose. The objective of this study was to assess the effectiveness and safety of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Methods Systematic review of clinical trials in English or French. Eight databases were searched. Included studies assessed the effectiveness of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Comparator and validated assessment tools were required. Studies were independently appraised by two investigators before data synthesis. Results The search yielded 1898 references, from which we identified 12 relevant articles evaluating highly heterogeneous outcomes. These were two randomised-controlled (RCTs), three non-randomised controlled, and seven non-randomised noncontrolled trials. In total, 392 participants were included and 185 were in RCTs. No study assessed the effectiveness of mirtazapine in alleviating symptoms at the same time, but some considered more than one symptom. Overall, the data was of poor quality, limited by small sample size and bias. However, mirtazapine showed effectiveness in treating depression, anxiety, sleep disorders, emesis and neuropathic pain. Across all studies, mirtazapine is safe to use, with drowsiness and dizziness the most common side-effects. Conclusion Study design and small sample sizes limit the ability to interpret results. Trials to assess the impact of mirtazapine or other medicines in alleviating multiple symptoms would be valuable.

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Patient Health Questionnaire Anxiety and Depression Scale: Initial Validation in Three Clinical Trials

Cited by 331 publications

References 79 publications

Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors

Self-reported depression symptoms in haemodialysis patients: Bi-factor structures of two common measures and their association with clinical factors

Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury

What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review

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