scholarly journals Validity and item response theory properties of the Patient Health Questionnaire-9 for primary care depression screening in Mozambique (PHQ-9-MZ)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Vasco F. J. Cumbe ◽  
Alberto Muanido ◽  
Maria Nélia Manaca ◽  
Hélder Fumo ◽  
Pedro Chiruca ◽  
...  
Salud Mental ◽  
2019 ◽  
Vol 42 (1) ◽  
pp. 43-50
Author(s):  
Sabrina Martins Barroso ◽  
Ana Paula Souto Melo ◽  
Mônia Aparecida da Silva ◽  
Mark Drew Crosland Guimarães

Introduction. The Patient Health Questionnaire (PHQ-9) is one of the most validated tools used to detect depressive episodes in Brazil. Objective. This study investigates the psychometric properties of the PHQ-9 using the Item Response Theory. Method. We used the gradual response model to assess depression in 764 residents of Brazilian rural communities of descended from slaves (quilombos) from the county of Vitória da Conquista, state of Bahia, Brazil, who had responded to PHQ-9. We estimated the parameters for item discrimination and difficulty. Results. The items of the PHQ-9 showed the ability to discriminate from moderate to very high. The items evaluating thoughts of hurting oneself and death showed the greatest discrimination while feeling depressed showed the lowest discrimination. Discussion and conclusion. The Item Response Theory enables advances in the analysis of the psychometric properties of the screening tools assessing depression, and indicates that PHQ-9 can be used in rural populations in Brazil.


2011 ◽  
Vol 52 (1) ◽  
pp. 96-101 ◽  
Author(s):  
Shen-Ing Liu ◽  
Zai-Ting Yeh ◽  
Hui-Chun Huang ◽  
Fang-Ju Sun ◽  
Jin-Jin Tjung ◽  
...  

Author(s):  
Carlos Arturo Cassiani-Miranda ◽  
Angy Karina Cuadros-Cruz ◽  
Harold Torres-Pinzón ◽  
Orlando Scoppetta ◽  
Jhon Henrry Pinzón-Tarrazona ◽  
...  

2020 ◽  
Author(s):  
Vasco Francisco Japissane Cumbe ◽  
Alberto Gabriel Muanido ◽  
Maria Nélia Manaca ◽  
Hélder Fumo ◽  
Pedro Chiruca ◽  
...  

Abstract Background: Depression is one of the leading causes of disability in Mozambique; however, few patients with depression are identified in primary care. To our knowledge, there are no validated tools for depression screening in Mozambique. The aim of this study was to validate the Patient Health Questionnaire-9 (PHQ-9) for use in primary care settings in Mozambique.Methods: The PHQ-9 was adapted using a structured multi-phase process led by a team of bilingual experts followed by a review by lay individuals and pilot-testing including cognitive interviews. The final Mozambican PHQ-9 (PHQ-9-MZ) was applied among 502 individuals randomly selected from antenatal, postpartum, and general outpatient consultations in three Ministry of Health primary healthcare clinics in Sofala Province, Mozambique. The PHQ-9-MZ was evaluated against the MINI 5.0-MZ as a gold standard diagnostic tool.Results: The majority of participants were female (74%), with a mean age of 28. Using the MINI 5.0-MZ, 43 (9%) of the sample tested positive for major depressive disorder. Items of the PHQ-9-MZ showed good discrimination and factor loadings. One latent factor of depression explained 54% of the variance in scores. Questions 3 (sleep) and 5 (appetite) had the lowest item discrimination and factor loadings. The PHQ-9-MZ showed good internal consistency, with a Cronbach’s alpha of 0.84, and an area under the receiver operating characteristic curve (AUROC) of 0.81 (95% CI: 0.73, 0.89). The PHQ-2-MZ had an AUROC of 0.78 (95% CI: 0.70, 0.85). Using a cut-point of ≥9, the PHQ-9-MZ had a sensitivity of 46.5% and a specificity of 93.5%. Using a cut-point of ≥2, the PHQ-2-MZ had a sensitivity of 74.4% and a specificity of 71.7%. Increasing the cut-point to ≥3, the PHQ-2-MZ has a sensitivity of 32.6% and a specificity of 94.6%. Conclusions: The PHQ-9-MZ and PHQ-2-MZ emerge as two valid alternatives for screening for depression in primary health care settings in Mozambique. Depending on program needs and weighing the value of minimizing false positives and false negatives, the PHQ-9-MZ can be employed with cut-points ranging from ≥8 to ≥11, and the PHQ-2-MZ with cut-points ranging from ≥2 to ≥3.


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