Validity and item response theory properties of the Patient Health Questionnaire-9 for primary care depression screening in Mozambique (PHQ-9-MZ)

Cumbe, Vasco; Muanido, Alberto; Manaca, Maria Nélia; Fumo, Hélder; Chiruca, Pedro; Hicks, Leecreesha; Mari, Jair de Jesus; Wagenaar, Bradley H.

doi:10.1186/s12888-020-02772-0

Cited by 20 publications

(24 citation statements)

References 29 publications

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“…Low sensitivity and specificity of the PHQ-9 and the GAD-7 was previously reported in other studies. For example, in the sample of Mozambique primary care patients the PHQ-9 cut-off value of ≥9 demonstrated low sensitivity (46.5%) but satisfactory specificity (93.5%) [ 18 ]. In a sample of general Swiss general hospital patients, the PHQ-9 showed an acceptable level of specificity.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, it is one of the most frequently used and most validated measures of depression worldwide, which has been translated into over 70 languages [ 16 ]. The PHQ-9 is recognized as a valid and reliable instrument for screening of depression in the general population [ 10 , 17 ], in clinical settings [ 18 – 21 ] and the university context [ 22 , 23 ]. It has sufficient concordance with recognized clinical measures of depression such as the Composite International Diagnostic Interview, CIDI [ 10 ], the Structural Clinical Interview for DSM Disorders, SCID [ 24 ] and the MINI-International Neuropsychiatric Interview, M.I.N.I.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…Data were collected using the Mini International Neuropsychiatric Interview (MINI 5.0-MZ) adapted to the Mozambican context [ 24 ] from the existing Brazilian Portuguese version of the MINI 5.0 [ 25 ]. The MINI 5.0-MZ includes a structured psychiatric interview for all common mental disorders and one section for suicide risk screening.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and correlates of suicidal behavior in primary care settings in Mozambique

et al. 2022

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Background This study assessed the prevalence of suicidal behavior and associated risk factors in public primary health care in Mozambique. Methods The Mini International Neuropsychiatric Interview was used to evaluate suicidal behavior among 502 adults attending three Primary Health Care (PHC) settings. Results In the past month, 13% (n = 63) of PHC attendees expressed suicidal ideation, 8% (n = 40) had made a suicide plan, 4% (n = 20) had made a suicide attempt, and 5% (n = 25) reported a lifetime suicide attempt. Females had 2.8-fold increased odds of suicide plan (95% CI: 1.5, 5.5) and 3.3-fold increased odds of suicide attempt in the past month (95% CI: 1.2, 9.1). Each 10-year increase in age was associated with 0.61-fold the odds of suicide plan (95% CI: 0.38, 0.98) and 0.09-fold the odds of suicide attempt (95% CI: 0.01, 0.69) in the past month. People living with HIV (PLWHA) had 2.2-fold increased adjusted odds of past month suicide attempt (CI: 1.1, 4.1). Conclusion Suicidal behaviors are common among adults attending PHC clinics in Mozambique. Screening and linkage to effective preventive interventions are urgently needed in PHC settings. Females, younger individuals, and PLWHA are at elevated risk for suicidal behavior in PHC.

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“…This was a cross-sectional, observational study [28] that used the World Health Organization's STEPwise Approach to Surveillance (WHO-STEPS) tool to obtain socio -demographic data as well as, tobacco and alcohol use and the Personal Health Questionnaire (PHQ-9) to assess prevalence of depression in a sample of adults presenting to the emergency department for acute care [ 29 , 30 ]. The WHO-STEPS tool and PHQ-9 are both validated and widely used tools, with proven relevance for LMICs [31] , [32] , [33] , [34] . Two data collectors trained in qualitative methods and interviewing were hired and received a two-week onboarding regarding the study protocol and study recruitment site.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and correlates of depression and substance use disorders in emergency department populations: A cross-sectional study at East Africa's largest public hospital

Iheanacho

Maciejewski

Ogudebe

et al. 2022

African Journal of Emergency Medicine

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Validity and item response theory properties of the Patient Health Questionnaire-9 for primary care depression screening in Mozambique (PHQ-9-MZ)

Cited by 20 publications

References 29 publications

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

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

Prevalence and correlates of suicidal behavior in primary care settings in Mozambique

Prevalence and correlates of depression and substance use disorders in emergency department populations: A cross-sectional study at East Africa's largest public hospital

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