Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina

María Urtasun1, Federico Manuel Daray2, Germán Leandro Teti3, Fernando Coppolillo4, Gabriela Herlax4, Guillermo Saba5, Adolfo Rubinstein1, Ricardo Araya6, Vilma Irazola1
1South American Center of Excellence in Cardiovascular Health (CESCAS), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
2Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
3Emergency Acute Inpatient Unit, “Braulio A. Moyano” Neuropsychiatric Hospital, Buenos Aires, Argentina
4Family Medicine Department, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
5Center of psychology, psychiatry and mental health Horus, Buenos Aires, Argentina
6Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK

Tóm tắt

Abstract Background

The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina.

Methods

We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed.

Results

One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach’s alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson’s correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6–8 for mild cases, 9–14 for moderate and 15 or more for severe depressive symptoms respectively.

Conclusions

The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.

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