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Psychometric properties and clinical utility of brief measures of depression, anxiety, and general distress: The PHQ-2, GAD-2, and K-6
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OBJECTIVE: The nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), and ten-item Kessler Psychological Distress Scale (K-10) are valid and reliable measures of depression, anxiety and general distress. However, the time required in their administration may limit their use in routine care. This study examines the utility of shorter versions (PHQ-2, GAD-2, and K-6) as screening instruments and measures of treatment response. METHOD: Data from research trial participants (n = 993) receiving internet-delivered cognitive behaviour therapy (iCBT) were analysed to establish discriminant validity of the short versions. Mini International Neuropsychiatric Interview (MINI) diagnoses were used as comparators. Criterion group validity, test-retest reliability, internal consistency, and responsiveness to treatment changes were examined. Analyses were replicated using data from patients receiving iCBT in routine care (n = 1389). RESULTS: Discriminant validity was excellent for the PHQ-2, and acceptable for the GAD-2 and K-6. Acceptable sensitivity and specificity were identified at a threshold of ≥3 for the PHQ-2 and GAD-2, and ≥14 for the K-6. The short versions were sensitive to treatment change. CONCLUSION: The PHQ-2, GAD-2 and K-6 are useful screeners and efficient measures of treatment progress and outcomes in routine clinical care.
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“The brief versions of the tools (ie, the PHQ-2 and the GAD-2) have previously been demonstrated to be reliable and valid for assessing change over time in clinical samples, with test-retest reliability of 0.79 for the PHQ-2 and 0.81 for the GAD-2 [35].”
From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [35]
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“The brief versions of the tools have previously been demonstrated to be reliable and valid for assessing change over time in clinical samples [35]”
From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [35]
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Cites
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Firew, T., Sano, E. D., Lee, J. W., Flores, S., Lang, K. J., Salman, K., Greene, M. C., & Chang, B. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-042752 · Cited by 302
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Byrd‐Bredbenner, C., Eck, K., & Quick, V. (2021) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2021.01.002 · Cited by 195
Xu, W., Павлова, Ю., Chen, X., Petrytsa, P., Graf‐Vlachy, L., & Zhang, S. X. (2023) · International Journal of Social Psychiatry · doi:10.1177/00207640221143919 · Cited by 176
Metadata
- Authors
- Staples, L. G., Dear, B. F., Gandy, M., Fogliati, V., Fogliati, R., Karin, E., Nielssen, O., & Titov, N.
- Affiliations
- Macquarie University (AU)
- Corresponding author
- Staples, Lauren G.
- ORCID
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 56
- Pages
- 13-18
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2900873257
- Cited by
- 405
- References
- 30
- Citations by year
- 2026: 56 · 2025: 83 · 2024: 64 · 2023: 62 · 2022: 62 · 2021: 55 · 2020: 17 · 2019: 6
- FWCI
- 25.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- General Hospital Psychiatry (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Australian National Health and Medical Research Council (630560)
- 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 › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- PHQ-2, GAD-2, K-6, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Kessler Psychological Distress Scale, depression screening, anxiety screening, psychological distress, brief screening instrument, internet-based cognitive behavioral therapy, treatment response assessment, discriminant validity, sensitivity and specificity, test-retest reliability, internal consistency
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychometrics, Sensitivity and Specificity, Stress, Psychological, Reproducibility of Results, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care
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