Article2012

Psychometrics of the PHQ-9 as a measure of depressive symptoms in patients with heart failure

Muna Hammash · Lynne A. Hall · Terry A. Lennie · Seongkum Heo · Misook Lee Chung · Kyoung Suk Lee +1 more

162 citations0/0 files storedEuropean Journal of Cardiovascular Nursing

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Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Cardiac Health and Mental Health Health Education and Validation

Abstract

BACKGROUND: Depression in patients with heart failure commonly goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) is a simple, valid measure of depressive symptoms that may facilitate clinical assessment. It has not been validated in patients with heart failure. AIMS: To test the reliability, and concurrent and construct validity of the PHQ-9 in patients with heart failure. METHODS: A total of 322 heart failure patients (32% female, 61 ± 12 years, 56% New York Heart Association class III/IV) completed the PHQ-9, the Beck Depression Inventory-II (BDI-II), and the Control Attitudes Scale (CAS). RESULTS: Cronbach's alpha of .83 supported the internal consistency reliability of the PHQ-9 in this sample. Inter-item correlations (range .22-.66) and item-total correlation (except item 9) supported homogeneity of the PHQ-9. Spearman's rho of .80, (p < .001) between the PHQ-9 and the BDI-II supported the concurrent validity as did the agreement between the PHQ-9 and the BDI-II (Kappa = 0.64, p < .001). At cut-off score of 10, the PHQ-9 was 70% sensitive and 92% specific in identifying depressive symptoms, using the BDI-II scores as the criterion for comparison. Differences in PHQ-9 scores by level of perceived control measured by CAS (t(318) = -5.05, p < .001) supported construct validity. CONCLUSION: The PHQ-9 is a reliable, valid measure of depressive symptoms in patients with heart failure.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2001The PHQ-9 2012Diagnostic and Statistical Manual of Mental Disorders 1999Validation and Utility of a Self-report Version of PRIME-MD The PHQ Primary Care Study 1994Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study 2012Beck Depression Inventory 1994Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care 2005Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population

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