Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan
Abstract
Purpose The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire (PHQ-9) for the purpose of screening major depressive disorder (MDD) among primary care patients in Taiwan.Method A total of 1954 primary care patients completed the PHQ-9. Patients (n = 1532) were interviewed using the Schedule for Clinical Assessments in Neuropsychiatry and 17-item of Hamilton Rating Scale. Subsample cases were retested within 2 weeks.Results The PHQ-9 had a good internal consistency (α = .80) and test-retest reliability (intraclass correlation coefficient = 0.87). A principal component factor analysis yielded 1-factor structure, which accounted for a total of 42.0% of the variance. The PHQ-9 was significantly correlated with the external validators such as the 17-item of Hamilton Rating Scale and the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (P < .001). Using the Schedule for Clinical Assessments in Neuropsychiatry interview as the criterion standard, a PHQ-9 score of 10 or higher had a sensitivity of 0.86 and a specificity of 0.94 for recognizing MDD. The screening accuracy of the 2 items version, PHQ-2, was also satisfactory (scores ≥ 2: sensitivity 0.88; specificity 0.82). The single-question screen, PHQ-1 (depressed mood), was 78% sensitive and 93% specific for detecting MDD (score ≥ 2).Conclusion The PHQ-9 and its 2 subscales, PHQ-2 and PHQ-1, seem reliable and valid for detecting MDD among Chinese primary care patients.
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Use of Mandarin PHQ-9 cutoff score ≥10 is associated with high sensitivity (0.86) for diagnosis of depression.
“Use of Mandarin PHQ-9 cutoff score ≥10 was associated with a high sensitivity (0.86) for the diagnosis of depression.”
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“The 9-items Patient Health Questionnaire (PHQ-9) [33]: We used the Mandarin version of PHQ-9 to screen the participants for the presence of depression.”
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- Authors
- Liu, S.-I., Yeh, Z.-T., Huang, H.-C., Sun, F.-J., Tjung, J.-J., Hwang, L.-C., Shih, Y.-H., & Yeh, A. W.-C.
- Affiliations
- Mackay Memorial Hospital (TW)
- Fu Jen Catholic University (TW)
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 52
- Issue
- 1
- Pages
- 96-101
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2025782658
- Cited by
- 192
- References
- 36
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 18 · 2023: 10 · 2022: 26 · 2021: 17 · 2020: 19 · 2019: 9 · 2018: 12 · 2017: 12 · 2016: 10 · 2015: 4 · 2014: 8 · 2013: 8 · 2012: 6
- FWCI
- 7.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Health Research Institutes
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Patient Health Questionnaire, PHQ-9, depression screening, major depressive disorder, Chinese version, primary care patients, psychometric validation, test-retest reliability, internal consistency, PHQ-2, sensitivity and specificity, Hamilton Depression Rating Scale, quality of life
- MeSH terms
- Adult, Major Depressive Disorder, Female, Humans, Male, Personal Satisfaction, Primary Health Care, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Taiwan, Reproducibility of Results
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