The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital
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RESEARCH ARTICLE
Open Access
The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital Yue Sun1,2†, Zhaoyan Fu1,2†, Qijing Bo1,2* , Zhen Mao1,2, Xin Ma1,2 and Chuanyue Wang1,2
Abstract Background: To assess the reliability and validity of Patient Health Questionnaire-9 (PHQ-9) for patients with major depressive disorder (MDD) and to assess the feasibility of its use in psychiatric hospitals in China. Methods: One hundred nine outpatients or inpatients with MDD who qualified the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria completed PHQ-9 and Hamilton Depression Scale (HAMD-17). Two weeks after the initial evaluation, 54 randomly selected patients underwent repeat assessment using PHQ-9. For validity analysis, the construct validity and criterion validity were assessed. The internal concordance coefficient and the test-retest correlation coefficients were used for reliability analysis. The correlation between total score and scores for each item and the correlation between scores for various items were evaluated using Pearson correlation coefficient. Results: Principal components factor analysis showed good construct validity of the PHQ-9. PHQ-9 total score showed a positive correlation with HAMD-17 total score (r = 0.610, P < 0.001). With HAMD as the standard, PHQ-9 depression scores of 7, 15, and 21 points were used as cut-offs for mild, moderate, and severe depression, respectively. Consistency assessment was conducted between the depression severity as assessed by PHQ-9 and HAMD (Kappa = 0.229, P < 0.001). Intraclass correlation coefficient between PHQ-9 total score and HAMD total score was 0.594 (95% confidence interval, 0.456–0.704, P < 0.001). The Cronbach’s α coefficient of PHQ-9 was 0.892. Correlation coefficients between each item score and the total score ranged from 0.567–0.789 (P < 0.01); the correlation coefficient between various item scores ranged from 0.233–0.747. The test-retest correlation coefficient for total score was 0.737. Conclusions: PHQ-9 showed good reliability and validity, and high adaptability for patients with MDD in psychiatric hospital. It is a simple, rapid, effective, and reliable tool for screening and evaluation of the severity of depression. Keywords: PHQ-9, Reliability, Validity, Major depressive disorder
* Correspondence: [email protected] † Yue Sun and Zhaoyan Fu contributed equally to this work. 1 The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing 100088, China 2 Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in a
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