Validation of the patient health questionnaire-9 and the generalized anxiety disorder-7 in Lithuanian student sample

Abstract

Background The Patient Health Questionnaire—9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire– 7 (GAD-7) are short screening instruments used for detection of depression and anxiety symptoms in various settings, including general and mental health care as well as the general population. The aim of this study is to evaluate psychometric properties and factorial structure of the PHQ-9 and the GAD-7 in a sample of Lithuanian university students. Methods 1368 students (mean age 22.5±4.8) completed the PHQ-9 and the GAD-7 questionnaires online; after the completion of the survey, students were asked to provide phone contact for an additional interview. Eligible students were approached later by trained interviewers and completed The Clinical Interview Schedule-Revised for assessment of depressive and anxiety disorders. Results Results showed that the PHQ-9 and the GAD-7 are reliable screening tools for depression and anxiety (Cronbach alpha 0.86 and 0.91, respectively). The one-factor structure of the PHQ-9 and the GAD-7 was confirmed by the Confirmatory Factor Analysis. A cut-off of ≥10 for the PHQ-9 resulted in 71% sensitivity and 66% specificity recognizing students with increased risk for mood or anxiety disorder. For the GAD-7, a cut-off ≥9 resulted in 73% sensitivity and 70% specificity recognizing students at risk. The PHQ-9 was sensitive but not specific in recognizing students with depressive disorders. The sensitivity and specificity of the GAD-7 in differentiating students with generalized anxiety disorders were low. Conclusions The PHQ-9 and the GAD-7 have sufficient formal psychometric properties, but their clinical utility as diagnostic tools for recognition of depressive and anxiety disorders in students is limited. Due to low specificity and high false positive rates, both scales are recommended only as an initial screening tool for recognition of subjects with increased risk of mental disorders, however positive cases should be later assessed using more comprehensive instruments.

Beyond the Digital Competencies of Medical Students: Concerns over Integrating Data Science Basics into the Medical Curriculum

“…Depression was measured with the nine-item Patient Health Questionnaire (PHQ-9), validated for the Romanian population [ 22 , 23 ] and proven to be a valid screening tool for depression in various settings (i.e., not only in clinical settings, as initially developed) and also for the general population [ 24 , 25 , 26 , 27 ].…”

Factors associated with worsened clinical symptoms of psoriasis and disease-related quality of life during the COVID-19 lockdown: A cross-sectional study

“…In the next two parts of the evaluation, two standardized questionnaires were used: the Dermatology Life Quality Index (DLQI) ( 33 ) and the Patients' Health Questionnaire-9 (PHQ-9) ( 34 , 35 ).…”

“…The PHQ-9 is a brief self-rated questionnaire, which is part of the PHQ for the assessment of the severity of depressive symptoms during the past 2 weeks. The questionnaire consists of nine items that fit the Diagnostic and Statistical Manual-IV diagnostic criteria for major depressive disorder ( 34 , 35 ). For each question, one of the four responses should be marked to describe how often the symptom in question has occurred in the last 2 weeks, with each of the nine items scored according to a Likert scale from 0 (“not at all”) to 3 (“nearly every day”).…”

“…The severity of depressive symptoms was assessed by the sum of the scores of the nine items, and ranges from 0 to 27, where higher scores indicate more severe depressive symptoms. A threshold of ≥10 for the PHQ-9 was considered to indicate an increased risk for depression ( 35 ). There was an additional question that asked the respondent to assess how the depressive symptoms were affecting their everyday life, work activities or communication with other people, with self-ratings of: “not difficult at all”, “somewhat difficult”, “very difficult”, and “extremely difficult”.…”

Mental Health and Wellbeing in Lithuanian Medical Students and Resident Doctors During COVID-19 Pandemic

“…The survey consisted of scales measuring general wellbeing (the WHO–Five Wellbeing Index (WHO-5) and Cronbach’s α was 0.88) ( 42 , 43 ), sleeping patterns (Pittsburg sleep quality index (PSQI) and Cronbach’s α was 0.71) ( 44 , 45 ), depression symptoms (Patient Health Questionnaire (PHQ-9) and Cronbach’s α was 0.84) ( 46 ), and anxiety symptoms (Generalized Anxiety Disorder Assessment (GAD-7) and Cronbach’s α was 0.91) ( 47 , 48 ). Questions about socio-demographic characteristics, such as participants’ sex, age, living conditions, family situation, physical activity, academic achievements, and participation in academic classes were developed by the researchers.…”