The PHQ-2, PHQ-8, and PHQ-9 demonstrated good diagnostic accuracy for detecting major depression in primary care, with optimal cut-off values of ≥2, ≥7, and ≥8, respectively.
Cross-Sectional (n=2,579)
Yes
Do the PHQ-2, PHQ-8, and PHQ-9 accurately detect major depression in primary health care patients in Spain?
The PHQ-2, PHQ-8, and PHQ-9 are valid and reliable tools for screening major depression in Spanish primary health care patients, with optimal cut-offs of ≥2, ≥7, and ≥8 respectively.
Effect estimate: AUC 0.91 for PHQ-9, 0.90 for PHQ-8, and 0.85 for PHQ-2 (95% CI 0.874-0.949)
p-value: p=<0.001
BACKGROUND: Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. METHODS: The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. RESULTS: The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. CONCLUSIONS: PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain.
Gómez‐Gómez et al. (2022) conducted a cross-sectional in Major depression (n=2,579). PHQ-2, PHQ-8, and PHQ-9 vs. CIDI diagnostic interview was evaluated on Diagnostic accuracy (Area Under the Curve) for detecting major depression (AUC 0.91 for PHQ-9, 0.90 for PHQ-8, and 0.85 for PHQ-2, 95% CI 0.874-0.949, p=<0.001). The PHQ-2, PHQ-8, and PHQ-9 demonstrated good diagnostic accuracy for detecting major depression in primary care, with optimal cut-off values of ≥2, ≥7, and ≥8, respectively.