Utility of the PHQ-9 to identify major depressive disorder in adult patients in Spanish primary care centres

Abstract

BackgroundThe prevalence of major depressive disorder (MDD) in Spanish primary care (PC) centres is high. However, MDD is frequently underdiagnosed and consequently only some patients receive the appropriate treatment. The present study aims to determine the utility of the Patient Health Questionnaire-9 (PHQ-9) to identify MDD in a subset of PC patients participating in the large PsicAP study.MethodsA total of 178 patients completed the full PHQ test, including the depression module (PHQ-9). Also, a Spanish version of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was implemented by clinical psychologists that were blinded to the PHQ-9 results. We evaluated the psychometric properties of the PHQ-9 as a screening tool as compared to the SCID-I as a reference standard.ResultsThe psychometric properties of the PHQ-9 for a cut-off value of 10 points were as follows: sensitivity, 0.95; specificity, 0.67. Using a cut-off of 12 points, the values were: sensitivity, 0.84; specificity, 0.78. Finally, using the diagnostic algorithm for depression (DSM-IV criteria), the sensitivity was 0.88 and the specificity 0.80.ConclusionsAs a screening instrument, the PHQ-9 performed better with a cut-off value of 12 versus the standard cut-off of 10. However, the best psychometric properties were obtained with the DSM-IV diagnostic algorithm for depression. These findings indicate that the PHQ-9 is a highly satisfactory tool that can be used for screening MDD in the PC setting.Trial registrationCurrent Controlled Trials ISRCTN58437086. Registered 20 May 2013.

Positive and Negative Affect Schedule (PANAS): psychometric properties of the online Spanish version in a clinical sample with emotional disorders

“…Cronbach alpha for the questionnaire was .89, and test-retest reliability was also excellent [50]. The Spanish validation of the PHQ-9 has demonstrated a good internal consistency in a sample of primary care patients (α = .89) [51]. Cronbach alpha for the PHQ-9 in this study was good (.85).…”

Characteristics, management and medical costs of patients with depressive disorders admitted in primary and specialised care centres in Spain between 2011 and 2016

“…The patient profile described in this study is comparable to previous evaluations. The increased percentage of female patients in primary care settings has been previously described in Spain [11,20]. On average, the patients that access specialised care are slightly younger and are mostly diagnosed with a severe disorder, which is not surprising given the low detection rate of mild forms of depression [21].…”

A Common Goal: Primary Care and Psychiatry Improve Depression Detection and Outcomes

“…A PHQ-9 score of 10 or above has an 88% sensitivity and 88% specificity for MDD. (Muñoz-Navarro et al, 2017) Use of the PHQ-9 to aid diagnosing and tracking depression is recommended by the World Health Organization, American Psychiatric Association Practice Guidelines for the treatment of Patients with MDD, and the Cochrane Review for Collaborative Care of Depression. (American Psychiatric Association, 2010;Archer et al, 2012;World Health Organization, 2001)…”