The 5-Item Who Well-Being Index as a Screening Tool for Depression in a Population of Doctors and Nurses in Nigeria during the COVID-19 Pandemic

Abstract

Background: Undetected depression can result in a significant decline in productivity among the workforce in every system, the healthcare sector inclusive. It is vital to utilize brief screening tools to detect populations at risk of depression. The 5-item WHO Well-being Index (WHO-5) has been used as a screening measure for depression, but research on this is scarce in sub-Saharan Africa. This study aimed to determine the utility and validity of the WHO-5 in screening for depression in a population of doctors and nurses in Nigeria during the COVID-19 pandemic. Methods: A representative sample of medical doctors and nurses across Nigeria (n = 464), completed the 5-item World Health Organization Well-Being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9). Results: The pattern of factors associated with cases of a positive depression screening was considerably similar for the WHO-5 and the PHQ-9. At a cut-off score of 50 for the WHO-5, the sensitivity and specificity values obtained were 0.857 and 0.851 respectively. Positive and negative predictive values were 0.404 and 0.981 respectively. ROC analysis of the WHO-5 against the PHQ-9 revealed that, at a cut-off of 50, the sensitivity of the WHO-5 was 0.857, 1-specificity was 0.152. The AUC was 0.918 (95% CI 0.884-0.953). Also, there was a strong, negative correlation between the WHO and the PHQ-9 scores (r = −0.590, p ≤ 0.0001). Conclusion: The WHO-5 well-being index has satisfactory validity as a screening tool for the detection of depression. It is also feasible for use in very busy settings, because of its brevity and ease of administration.

Validation of the WHO-5 Well-Being Scale among Adolescents in Ghana: Evidence-Based Assessment of the Internal and External Structure of the Measure

“…These results are indications that the one-factor structure estimates better regarding the well-being of adolescents. These findings are in agreement with previous validation studies [ 14 , 20 , 39 , 42 , 43 , 46 , 48 ]. This implies that the well-being of adolescents in Ghana could be explained by a single underlying trait likewise adolescents of other countries.…”

“…Numerous studies have assessed the validity and psychometric properties of the WHO-5 well-being index across different geographical contexts such as in Europe [ 35 , 39 , 40 ], Asia [ 41 , 42 , 43 , 44 ], and Africa [ 45 , 46 ]. For example, in Europe, Sischka et al [ 35 ] used item response theory and the analysis of measurement invariance across 35 countries and discovered that the model appropriately fitted the data for all countries.…”

“…Similar findings were also reported in other studies in China [ 55 , 56 ]; Japan [ 23 , 57 , 58 ]; Iran/Persia [ 41 , 44 , 59 , 60 ]; Thailand [ 61 ]; and Lebanon [ 62 ]. In Africa, Seb-Akahomen et al [ 46 ] established that the WHO-5 well-being index has satisfactory validity as a screening tool for the detection of depression in Nigeria. The sensitivity and specificity values obtained were 0.857 and 0.851, respectively.…”

Validity and reliability of the world health organisation-five well being index (WHO-5) questionnaire in early detection of depression during Covid-19 pandemic in Yogyakarta

“…However, the WHO-5 questionnaire is not designed to definitely diagnose depressive disorders, thus, further investigation should be considered. Besides, several other studies have proven the validity and reliability of the WHO-5 questionnaire (Seb-Akahomen et al, 2021).…”

Validation and Optimal Cut-Off Score of the World Health Organization Well- being Index (WHO-5) as a Screening Tool for Depression among Patients with Schizophrenia

“…Beyond its usefulness in the measurement and monitoring of well-being, the WHO-5 was found to be one of the main measures which has extensively demonstrated su cient validity to screen for and early detect depression in different clinical and non-clinical populations across several settings, cultures and countries. Indeed, the WHO-5 showed clinical utility in the screening for depressive symptoms in community adults [29][30][31], university students [32], healthcare workers during the COVID-19 [33], older adults residing in nursing homes [34], as well as in various clinical populations, including patients with diabetes [35][36][37][38], people diagnosed with Parkinson's disease [39], cardiac patients [40], acne vulgaris patients [41], child and adolescent patients from pediatric hospitals [42], and adolescents with major depressive disorder [43]. A systematic review of the literature by Topp et al [23] encompassing 213 studies revealed that the WHO-5 is sensitive and speci c screening instrument for depression, and has a very high applicability across research elds.…”