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Diagnostic accuracy of the mood module of the Patient Health Questionnaire: a systematic review
Abstract
Objective The nine-item mood module of the Patient Health Questionnaire (PHQ-9) was developed to screen and to diagnose patients in primary care with depressive disorders. We systematically reviewed the psychometric literature on the PHQ-9 and performed a meta-analysis to ascertain its summary sensitivity and specificity.Methods EMBASE, PubMed and PsycINFO were used to search literature up to July 2006. Studies were included if (1) they investigated the diagnostic accuracy of the PHQ-9 and (2) the PHQ-9 had been compared with a reference test. The quality of the studies was appraised using the Quality Assessment of Diagnostic Accuracy Studies. We calculated sensitivity, specificity and confidence intervals for each included study. We used the random effects model to calculate the summary sensitivity and specificity.Results We found a sensitivity of 0.77 (0.71-0.84) and a specificity of 0.94 (0.90-0.97) for the PHQ-9. The positive predictive value in an unselected primary care population was 59%, which increased to 85-90% when the prior probability increased to 30-40%.Conclusion In primary care, the PHQ-9 is a valid diagnostic tool if used in selected subgroups of patients with a high prevalence of depressive disorder.
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“Although the PHQ-9 is generally well validated and commonly used in primary care (Wittkampf et al. , 2007)”
From Do depressed and anxious men do groups? What works and what are the barriers to help seeking? (2014) · cites this paper as Wittkampf et al. , 2007
In the citing paper
“Earlier studies in primary care show that PHQ-9 detects depression with a sensitivity around 90% and a specificity ranging from 77% to 88% when using the cut-off ≥ 10. 15,17,23,24”
From Comparison of two self-rating scales to detect depression: HADS and PHQ-9 (2009) · cites this paper as [23]
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“[28] developed the bivariate meta-regression model to incorporate this relationship in calculating the summary sensitivity and specificity.”
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Metadata
- Authors
- Wittkampf, K. A., Naeije, L., Schene, A. H., Huyser, J., & van Weert, H. C.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Wittkampf, Karin A.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-09
- Volume
- 29
- Issue
- 5
- Pages
- 388-395
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2055505621
- Cited by
- 493
- References
- 40
- Citations by year
- 2026: 17 · 2025: 21 · 2024: 14 · 2023: 13 · 2022: 32 · 2021: 41 · 2020: 40 · 2019: 22 · 2018: 29 · 2017: 21 · 2016: 43 · 2015: 31 · 2014: 41 · 2013: 23 · 2012: 29
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- PHQ-9, Patient Health Questionnaire, depressive disorders, diagnostic accuracy, sensitivity and specificity, primary care, depression screening, positive predictive value, prior probability
- MeSH terms
- Depression, Diagnostic Errors, Humans, Netherlands, Primary Health Care, Psychometrics, Surveys and Questionnaires
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