Abstract
Abstract
Background
The lack of locally validated screening instruments contributes to poor detection of depression in primary care. The Patient Health Questionnaire-9 (PHQ-9) is a brief and freely available screening tool which was developed for primary care settings; however, its accuracy may be affected by the population in which it is administered. This study aimed to determine the validity and reliability of PHQ-9 for screening depression in a primary care population in Botswana.
Methods
Data was collected from a conveniently selected sample of 257 adult primary care attendants. The Mini International Neuropsychiatric Interview (MINI) depression module was used as a gold standard to assess criterion validity.
Results
Sensitivity and specificity of the PHQ-9 for screening for major depression were 72.4 and 76.3 respectively at a cut off score of nine or more. The area under the ROC curve was 0.808. The PHQ-9 demonstrated good internal consistency with a Cronbach alpha of 0.799. Criterion validity was demonstrated by significant correlation (r = 0.528, p < 0.001) between PHQ-9 and the MINI. Significant negative correlation between PHQ-9 scores and all four domains of the WHO quality of life questionnaire- brief version scores demonstrated good convergent validity.
Conclusions
The PHQ-9 is a reliable and valid instrument to screen for depression in primary care facilities in Botswana. Primary care clinicians in Botswana may use the PHQ-9 to screen for depression with a cut –off score of nine. Further studies should focus on integrating routine depression screening in primary care.
Funder
University of Botswana Office of Research and Development
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health
Reference32 articles.
1. American Heart Association. Depression after a cardiac event or diagnosis. 2015. Available from: http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Depression-and-Heart-Health_UCM_440444_Article.jsp#.WfGZiY-CzIU. Cited 26 Oct 2017.
2. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851–8 Available from: http://www.sciencedirect.com/science/article/pii/S0140673607614159. Cited 20 Apr 2017.
3. Kang H-J, Kim S-Y, Bae K-Y, Kim S-W, Shin I-S, Yoon J-S, et al. Comorbidity of depression with physical disorders: research and clinical implications. Chonnam Med J. 2015;51(1):8.
4. Voinov B, Richie WD, Bailey RK. Depression and chronic diseases: it is time for a synergistic mental health and primary care approach. Prim Care Companion CNS Disord. 2013;15(2) Available from: http://www.ncbi.nlm.nih.gov/pubmed/23930236. Cited 4 Sept 2018.
5. World Health Organization. WHO | WHO Mental Health Gap Action Programme (mhGAP).: WHO. World Health Organization; 2014. Available from: http://www.who.int/mental_health/mhgap/en/. Cited 20 Feb 2017.
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