People with diabetes need a lower cut-off than others for depression screening with PHQ-9

Abstract

Aims This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes. Methods Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden’s index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. Results The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden’s index and ≥ 5 by the two-stage method for screening for MDD and ‘MDD and/or dysthymia’ in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and ‘MDD and/or dysthymia’ among people without diabetes (Youden’s index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for ‘MDD and/or dysthymia’ in people without diabetes. Conclusions A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.

PAID-PL—The Polish Version of the Problem Areas in Diabetes Scale: Perfect Reliability and a One-Factor Structure

“…The Polish version of PHQ-9 has very good psychometric properties. 25 In our study sample, Cronbach α was 0.86.…”

“…Then, each of the participants completed the set of questionnaires including: World Health Organization-Five Well-Being Index (WHO-5), 22 , 23 Patient Health Questionnaire (PHQ-9), 24 , 25 The Problem Areas in Diabetes (PAID) 7 , 19 and the diagnosis of depression was conducted with the use of Mini-International Neuropsychiatric Interview (M.I.N.I.). 26 , 27…”

“…2) The Patient Health Questionnaire (PHQ-9) 24 , 25 which was used to measure the severity of depressive symptoms. We employed the Polish version of PHQ-9.…”

“…We employed the Polish version of PHQ-9. 25 This tool includes 9 items assessed on a 4-point Likert scale. Participants estimated the frequency of occurrence of certain states ranging from 0 (not at all) to 3 (nearly every day).…”

Underdiagnosis of Major Depressive Episodes in Hemodialysis Patients: The Need for Screening and Patient Education

“…has a sensitivity of 97% and a specificity of 67% for the diagnosis of MDD [ 39 ]. Readily available tools—the Patient Health Questionnaire 9 (PHQ-9) [ 40 , 41 , 42 ] and the World Health Organization-Five Well-Being Index (WHO-5)—are also short and effective screening methods for depression [ 43 , 44 , 45 ].…”