Validation of the nine‐item P atient H ealth Q uestionnaire to screen for major depression in a C hinese primary care population
Abstract
INTRODUCTION: The aim of this study was to examine the reliability and validity of the nine-item Patient Health Questionnaire (PHQ-9) for screening depression in Chinese primary care settings. METHODS: In 100 randomly selected primary care clinics (PCC) of Hangzhou city, we recruited 2,639 patients (aged ≥18 years) and applied the PHQ-9 to screen for depression. Then, 280 of them were further interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual Disorders (SCID) for the diagnosis of major depression. Statistical analysis of the demographic data, reliability, validity and receiver-operator curve were performed. RESULTS: The mean administration time was 7 minutes, and the Cronbach's α was 0.89. The optimal cutoff score of 10 on the PHQ-9 revealed a sensitivity of 0.87, specificity of 0.81, and positive likelihood ratio of 5.04. The area under the receiver-operator curve in this study was 0.91 (95% confidence interval, 0.87-0.94). DISCUSSION: The PHQ-9 performs well and has acceptable psychometric properties for screening of patients with depression in a Chinese primary care population.
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The Chinese version of the PHQ-9 has shown excellent internal consistency (Cronbach's α = 0.89).
“The Chinese version of the PHQ-9 has shown excellent internal consistency (Cronbach's α = 0.89) (Chen et al., 2013).”
From Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial (2022) · cites this paper as Chen et al., 2013
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“The Chinese version of the PHQ-9 has shown excellent internal consistency (Cronbach ’ s α = 0.89) (Chen et al., 2013).”
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“…study, and did not suffer pathologically or clinically diagnosed physical or mental disease (the total score of Patient Health Questionnaire-9 (S. Chen et al. 2013; Kroenke et al. 2001; Wang et al. 2014), PHQ-9 < 20; the total score of Generalized Anxiety Disor-der-7 (Lin et al. 2021; Spitzer et…”
- Authors
- Chen, S., Fang, Y., Chiu, H., Fan, H., Jin, T., & Conwell, Y.
- Affiliations
- Zhejiang University (CN)
- Anhui Medical University (CN)
- Chinese University of Hong Kong (HK)
- Health Department of Shangcheng District Hangzhou City Hangzhou China
- University of Rochester Medicine (US)
- Corresponding author
- Chen, Shulin
- Venue
- Asia-Pacific Psychiatry
- Publisher
- Wiley
- Published
- 2013-03-27
- Volume
- 5
- Issue
- 2
- Pages
- 61-68
- ISSN
- 1758-5864 (ISSN-L)
- 1758-5872
- OpenAlex
- W1868754566
- Cited by
- 100
- References
- 48
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 14 · 2023: 3 · 2022: 14 · 2021: 11 · 2020: 12 · 2019: 6 · 2018: 3 · 2017: 3 · 2016: 5 · 2015: 2 · 2014: 2
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Asia-Pacific Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fundamental Research Funds for the Central Universities
- Fogarty International Center (R01TW008699)
- 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
- PHQ-9, Patient Health Questionnaire, major depressive disorder, depression screening, primary care, Chinese patients, psychometric validation, screening cut-off values, sensitivity and specificity, severe combined immunodeficiency
- MeSH terms
- Adolescent, Adult, Aged, China, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, ROC Curve, Young Adult
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