Standardization of the Korean Version of the Patient Health Questionnaire-4 (PHQ-4)

Abstract

Objective The Patient Health Questionnaire-4 (PHQ-4) has been used for screening owing to ease of use and brevity. In this study, we developed the Korean version of the PHQ-4 and tested its validity. Methods One hundred sixteen new adult outpatients at the Department of Psychiatry of the Korea University Ansan Hospital participated in the study. We simultaneously administered other depression/anxiety scales the Hamilton Rating Scale for Depression, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory. Results The mean PHQ-4 score was 6.52 (standard deviation = 3.45). Cronbach’s α was 0.792, and the intraclass correlation coefficient of test and 2-week interval retest was 0.827 ( p < 0.01). The Pearson correlation coefficients between the PHQ-4 total score and other depression/anxiety scales were all over 0.6. Confirmatory factorial analysis showed acceptable convergent validity and reliability but questionable discriminant validity for some model fit values. Conclusion The Korean version of the PHQ-4 has sufficient internal consistency, test-retest reliability, and construct validity, but its two-factor structure showed incompleteness. However, we suggest that it should be used as a brief screening measure for common psychiatric distress that warrants further detailed assessment, but not to separately assess the severity of depression and anxiety symptoms.

The factor structure and measurement invariance of the PHQ-4 and the prevalence of depression and anxiety in a Southeast Asian context amid the COVID-19 pandemic

“…Although the PHQ-4 has been validated in several samples globally (Cano-Vindel et al, 2018 ; Ghaheri et al, 2020 ; Khubchandani et al, 2016 ; Kim et al, 2021 ; Kocalevent et al, 2014 ; Kroenke et al, 2009 ; Löwe et al, 2010 ; Mills et al, 2015 ; Renovanz et al, 2019 ; Tibubos & Kröger, 2020 ), to date, no published study has examined the psychometric properties of PHQ-4 among community samples from the Philippines. Given that several studies have used the PHQ-4 to evaluate mental health outcomes during the COVID-19 pandemic (Bendau et al, 2020 ; Choi et al, 2020 ; Lai et al, 2020 ; Li et al, 2020 ; Petzold et al, 2020b ; Schnell & Krampe, 2020 ), validating this instrument in the Philippines can extend its applicability as a tool for non-clinical samples and can shed light to the current state of mental health in a Southeast Asian context.…”

Scrambler Therapy for Chronic Pain after Burns and Its Effect on the Cerebral Pain Network: A Prospective, Double-Blinded, Randomized Controlled Trial

“…To be included in the study, patients had to (i) be 18 years of age or older; (ii) have burn scars that had re-epithelialized after aseptic care or skin grafting; (iii) have complained of moderate or greater chronic neuropathic pain with reduced sensation in the burned area (≥5 points on a 10-point visual analog scale (VAS)) lasting for >3 months after the burn injury, despite receiving pharmaceutical treatment and/or physical therapy [ 22 , 23 ]; (iv) a burn on either right or left side of the body; and (v) be dominant in the right hand. Patients were excluded based on the following criteria: (i) a history of cardiac arrest; (ii) neurological disease, or brain surgery; (iii) unstable heart disease or presence of a cardiac pacemaker; (iv) pain resulting from other causes (e.g., neuromuscular diseases) as confirmed via imaging (radiography, ultrasonography, computed tomography, or MRI); (v) psychiatric disorders; (vi) abnormal renal function; (vii) contraindication for MRI; (viii) pregnancy; or (ix) a score of 8 or higher on the Korean version of the Hamilton depression rating scale (HDRS) [ 24 ]. Possible drug effects were minimized by excluding patients who were receiving extended-release morphine therapy.…”

“…Only the therapist had access to the allocation schedule, and all participants and evaluators were blinded to the treatment details. Depressive mood was assessed using the Korean version of the Hamilton Depression Rating Scale (HDRS) [ 24 ]. Patients were asked to score their mean pain intensity using the VAS and Brief Pain Intensity (BPI).…”

The Prevalence of Depression, Anxiety and Associated Factors among the General Public during COVID-19 Pandemic: a Cross-sectional Study in Korea

“…Participants' depression and anxiety were assessed using the standardized Korean version of the PHQ-4, which was developed, adapted, and published in a previous study with proving its acceptable validity and reliability. 10 The PHQ-4 is a self-report questionnaire consisting of the PHQ-2 and GAD-2, which are the shortened versions containing the first 2 items of the PHQ-9 developed to screen depressive disorders and GAD-7 developed to screen anxiety disorders, respectively. The PHQ-2 and GAD-2 consist of simple questions appropriate for large-scale epidemiological studies; they have also been validated in a population-based study.…”