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May 22, 2015BMC PsychiatryOpen Access

The validity of the Patient Health Questionnaire for screening depression in chronic care patients in primary health care in South Africa

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Why the study?

Is the PHQ-9 a valid screening tool for depression in chronic care patients in primary health care in South Africa?

Population

676 chronic care patients attending two primary health facilities in North West Province, South Africa…

Comparison

Patient Health Questionnaire and PHQ-2 screening… vs Structured Clinical Interview for DSM-IV…

Design

Cross-sectional, The research assistant did not appraise the participant or…

Authors

ABArvin BhanaSRSujit D. RathodOSOné Selohilwe

Discussion

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Overview

PHQ-9 shows acceptable validity for depression screening in South African chronic care; extends validation data but optimal cut-offs require prospective confirmation before routine adoption.

Structured PICO

Is the PHQ-9 a valid screening tool for depression in chronic care patients in primary health care in South Africa?

P
Population
676 chronic care patients (median age 47, 75% female) attending two primary health facilities in North West Province, South Africa, receiving routine chronic disease services (e.g., HIV, hypertension, diabetes).
I
Intervention
Patient Health Questionnaire (PHQ-9) and PHQ-2 screening tools
C
Comparator
Structured Clinical Interview for DSM-IV (SCID) diagnostic interview (reference standard)
O
Outcome
Diagnostic validity (Area under the receiver operator curve [AUROC], sensitivity, and specificity) for major depressive disorderpatient reported

The PHQ-9 is a valid and useful screening tool for major depressive disorder among chronic care patients in South African primary care settings, with an optimal cut-point of ≥9.

Limitations

  • Participants were drawn from only two clinics in North West province
  • Sample was predominantly female
  • Unable to establish test-retest reliability
  • Unable to establish inter-rater reliability
  • Unable to randomize the order of interviews (screening vs. diagnostic)

Cite This Study

Bhana et al. (2015) studied this question.

synapsesocial.com/papers/6a6f65c0f44fa9f079dcd3d1https://doi.org/10.1186/s12888-015-0503-0
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Also Consider

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  1. 1Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies2006 · 1,361 citations
  2. 2The mental health of people living with HIV/AIDS in Africa: a systematic review2009 · 273 citations