Validity of the Patient Health Questionnaire-9 in Assessing Depression Following Traumatic Brain Injury
Abstract
OBJECTIVE: To test the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) for diagnosing major depressive disorder (MDD) among persons with traumatic brain injury (TBI). DESIGN: Prospective cohort study. SETTING: Level I trauma center. PARTICIPANTS: 135 adults within 1 year of complicated mild, moderate, or severe TBI. MAIN OUTCOME MEASURES: PHQ-9 Depression Scale, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). RESULTS: Using a screening criterion of at least 5 PHQ-9 symptoms present at least several days over the last 2 weeks (with one being depressed mood or anhedonia) maximizes sensitivity (0.93) and specificity (0.89) while providing a positive predictive value of 0.63 and a negative predictive value of 0.99 when compared to SCID diagnosis of MDD. Pearson's correlation between the PHQ-9 scores and other depression measures was 0.90 with the Hopkins Symptom Checklist depression subscale and 0.78 with the Hamilton Rating Scale for Depression. Test-retest reliability of the PHQ-9 was r = 0.76 and kappa = 0.46 when using the optimal screening method. CONCLUSIONS: The PHQ-9 is a valid and reliable screening tool for detecting MDD in persons with TBI.
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The PHQ-9 has established psychometric properties and sensitivity to change in the general population and in TBI samples.
“the Patient health Questionnaire-9 (PhQ-9) was used to quantify depressive symptom severity; the instrument has established psychometric properties and sensitivity to change in the general population and in tBi samples (Fann et al. 2005;Kroenke et al. 2001;löwe et al. 2004).”
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- Authors
- Fann, J. R., Bombardier, C. H., Dikmen, S., Esselman, P., Warms, C. A., Pelzer, E., Rau, H., & Temkin, N.
- Affiliations
- University of Washington (US)
- Venue
- Journal of Head Trauma Rehabilitation
- Published
- 2005-11
- Volume
- 20
- Issue
- 6
- Pages
- 501-511
- ISSN
- 0885-9701 (ISSN-L)
- OpenAlex
- W2046496887
- Cited by
- 404
- References
- 9
- Citations by year
- 2026: 15 · 2025: 20 · 2024: 27 · 2023: 14 · 2022: 19 · 2021: 29 · 2020: 28 · 2019: 32 · 2018: 23 · 2017: 27 · 2016: 23 · 2015: 24 · 2014: 25 · 2013: 14 · 2012: 16
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Head Trauma Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R-01 HD39415, R01HD039415)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Keywords
- PHQ-9, traumatic brain injury, major depressive disorder, depression screening, screening validity, test-retest reliability, sensitivity and specificity, post-traumatic depression, Hopkins Symptom Checklist, Hamilton Depression Rating Scale
- MeSH terms
- Adult, Brain Injuries, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Probability, Prospective Studies, Psychiatric Status Rating Scales, Surveys and Questionnaires, Sensitivity and Specificity, Severity of Illness Index, Cohort Studies, Glasgow Coma Scale, Injury Severity Score, Incidence, Age Distribution, Sex Distribution, Risk Assessment
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