Articlegreen2012

Criterion validity of the PHQ-9 (Malay version) in a primary care clinic in Malaysia.

M S Sherina · Bruce Arroll · Felicity Goodyear‐Smith

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

Abstract

OBJECTIVE: This study was conducted to determine the validity of the 9-item Patient Health Questionnaire (PHQ-9) (Malay version) as a case-finding instrument for depression among women in a primary care clinic. METHODS: A cross sectional study was conducted in a primary care clinic in Malaysia. Consecutive adult women patients who attended the clinic during data collection were given self-administered questionnaires, which included the PHQ-9 (Malay version). Systematic weighted random sampling was used to select participants for Composite International Diagnostic Interviews (CIDI). The PHQ-9 was validated against the CIDI reference standard. RESULTS: The response rate was 87.5% for the questionnaire completion (895/1023), and 96.8% for the CIDI interviews (151/156). The prevalence of depression was 12.1% (based on PHQ-9 scores of 10 and above). The PHQ-9 had a sensitivity of 87% (95% confidence interval 71% to 95%), a specificity of 82% (74% to 88%), positive LR 4.8 (3.2 to 7.2) and negative LR 0.16 (0.06 to 0.40). CONCLUSIONS: The Malay version of the PHQ-9 was found to be a valid and reliable case-finding instrument for depression in this study. Together with its brevity, it is a suitable case-finding instrument to be used in Malaysian primary care clinics.

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References

2001The PHQ-9 2000Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures 2004The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)1997The validity of two versions of the GHQ in the WHO study of mental illness in general health care 2003Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative 1988The Composite International Diagnostic Interview 1994Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical review 2010Validation of PHQ-2 and PHQ-9 to Screen for Major Depression in the Primary Care Population

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