Abstract
Objective
To assess the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9)
as a screening instrument for depression in elderly patients with diabetes mellitus
(DM) and chronic obstructive pulmonary disease (COPD) without known depression.
Study Design and Setting
DM and COPD patients aged >59 years were selected from general practices. A test–retest
was conducted in 105 patients. Criterion validity, using the Mini International Neuropsychiatric
Interview psychiatric interview to diagnose major depressive disorder (MDD) and any
depressive disorder (ADD) as diagnostic standard, was evaluated for both summed and
algorithm-based PHQ-9 score in 713 patients. Correlations with quality of life and
severity of illness were calculated to assess construct validity.
Results
Cohen's kappa for the algorithm-based score was 0.71 for MDD and 0.69 for ADD. Correlation
for test–retest assessment of the summed score was 0.91. The algorithm-based score
had low sensitivity and high specificity, but both sensitivity and specificity were
high for the optimal cut-off point of 6 on the summed score for ADD (Se 95.6%, Sp
81.0%). Correlations between summed score and quality of life and severity of illness
were acceptable.
Conclusion
The summed PHQ-9 score seems a valid and reliable screening instrument for depression
in elderly primary care patients with DM and COPD.
Keywords
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Article info
Publication history
Published online: February 15, 2008
Accepted:
July 30,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
