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Cited by 126Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and AccessTreatment of Major Depression

The DOI matches its Crossref record; 20 of the 21 references it cites were found in a registry or an index.

The accuracy of Patient Health Questionnaire-9 in detecting depression and measuring depression severity in high-risk groups in primary care

Wittkampf, Karin, van Ravesteijn, Hiske, Baas, Kim, van de Hoogen, Henk, Schene, Aart, Bindels, Patrick, Lucassen, Peter, van de Lisdonk, Eloy, van Weert, Henk·2009·General Hospital Psychiatry
DOI 10.1016/j.genhosppsych.2009.06.001
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Abstract

Objective Only half of patients with depressive disorder are diagnosed by their family physicians. Screening in high-risk groups might reduce this hidden morbidity. This study aims to determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) in (a) screening for depressive disorder, (b) diagnosing depressive disorder and (c) measuring the severity of depressive disorder in groups that are at high risk for depressive disorder.Method We compared the performance of the PHQ-9 as a screening instrument and as a diagnostic instrument to that of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview, which we used as reference standard. Three high-risk groups of patients were selected: (a) frequent attenders, (b) patients with mental health problems and (c) patients with unexplained complaints. Patients completed the PHQ-9. Next, patients who were at risk for depression (based on PHQ scores) and a random sample of 20% of patients who were not at risk were selected for a second PHQ-9 and the reference standard (SCID-I). We assessed the adequacy of the PHQ-9 as a tool for severity measurement by comparing PHQ-9 scores with scores on the 17-item Hamilton Depression Rating Scale (HDRS-17) in patients diagnosed with a depressive disorder.Results Among 440 patients, both PHQ-9 and SCID-I were analyzed. The test characteristics for screening were sensitivity=0.93 and specificity=0.85; those for diagnosing were sensitivity=0.68 and specificity=0.95. The positive likelihood ratio for diagnosing was 14.2. The HDRS-17 was administered in 49 patients with depressive disorder. The Pearson correlation coefficient of the PHQ-9 to the HDRS-17 was r=.52 (P<.01).Conclusion The PHQ-9 performs well as a screening instrument, but in diagnosing depressive disorder, a formal diagnostic process following the PHQ-9 remains imperative. The PHQ-9 does not seem adequate for measuring severity.

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Metadata

Authors
Wittkampf, K., van Ravesteijn, H., Baas, K., van de Hoogen, H., Schene, A., Bindels, P., Lucassen, P., van de Lisdonk, E., & van Weert, H.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • Radboud University Nijmegen (NL)
Corresponding author
Wittkampf, Karin
ORCID
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2009-09
Volume
31
Issue
5
Pages
451-459
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/j.genhosppsych.2009.06.001
OpenAlex
W2149482727
Cited by
126
References
21
Citations by year
2026: 5 · 2025: 5 · 2024: 7 · 2023: 2 · 2022: 7 · 2021: 10 · 2020: 6 · 2019: 11 · 2018: 4 · 2017: 5 · 2016: 8 · 2015: 11 · 2014: 7 · 2013: 14 · 2012: 6
FWCI
10.14
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • General Hospital Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Funders
Radboud Universitair Medisch Centrum
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
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords
PHQ-9, depression screening, depression severity measurement, high-risk groups, primary care, frequent attenders, SCID-I, Hamilton Depression Rating Scale, diagnostic accuracy, sensitivity and specificity
MeSH terms
Depression, Female, Humans, Male, Mass Screening, Middle Aged, Netherlands, Primary Health Care, Surveys and Questionnaires, Sensitivity and Specificity, Severity of Illness Index

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