Assessing depression in primary care with the PHQ-9: Can it be carried out over the telephone?
Open accessAbstract
Background Telephone assessment of depression for research purposes is increasingly being used. The Patient Health Questionnaire 9-item depression module (PHQ-9) is a well-validated, brief, self-reported, diagnostic, and severity measure of depression designed for use in primary care (PC). To our knowledge, there are no available data regarding its validity when administered over the telephone.Objective The aims of the present study were to evaluate agreement between self-administered and telephone-administered PHQ-9, to investigate possible systematic bias, and to evaluate the internal consistency of the telephone-administered PHQ-9.Methods Three hundred and forty-six participants from two PC centers were assessed twice with the PHQ-9. Participants were divided into 4 groups according to administration procedure order and administration procedure of the PHQ-9: Self-administered/Telephone-administered; Telephone-administered/Self-administered; Telephone-administered/Telephone-administered; and Self-administered/Self-administered. The first 2 groups served for analyzing the procedural validity of telephone-administered PHQ-9. The last 2 allowed a test-retest reliability analysis of both self- and telephone-administered PHQ-9. Intraclass correlation coefficient (ICC) and weighted kappa (for each item) were calculated as measures of concordance. Additionally, Pearson's correlation coefficient, Student's t-test, and Cronbach's alpha were analyzed.Results Intraclass correlation coefficient and weighted kappa between both administration procedures were excellent, revealing a strong concordance between telephone- and self-administered PHQ-9. A small and clinically nonsignificant tendency was observed toward lower scores for the telephone-administered PHQ-9. The internal consistency of the telephone-administered PHQ-9 was high and close to the self-administered one.Conclusions Telephone and in-person assessments by means of the PHQ-9 yield similar results. Thus, telephone administration of the PHQ-9 seems to be a reliable procedure for assessing depression in PC.
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Previous evidence suggests that information gathering methods might not influence the results when assessing psychiatric disorders, particularly when using the PHQ.
“However, previous evidence suggests that the information gathering methods might not influence the results when assessing psychiatric disorders (Fenig et al., 1993;Rohde et al., 1997), and particularly when using the PHQ (Pinto-Meza et al., 2005).”
From Prevalence and age patterns of depression in the United Kingdom. A population-based study (2021) · cites this paper as Pinto-Meza et al., 2005
The telephone-administered version of the Patient Health Questionnaire (PHQ-9) showed adequate reliability (α=0.82).
“The telephone-administered version of the PHQ-9 showed adequate reliability (α=0.82),43”
From Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study) (2020) · cites this paper as [43]
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- Authors
- Pinto-Meza, A., Serrano-Blanco, A., Peñarrubia, M. T., Blanco, E., & Haro, J. M.
- ORCID
- Haro, Josep Maria
- Venue
- Journal of General Internal Medicine
- Published
- 2005-08
- Volume
- 20
- Issue
- 8
- Pages
- 738-742
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC1490180
- OpenAlex
- W2037263999
- Cited by
- 347
- References
- 23
- Citations by year
- 2026: 1 · 2025: 13 · 2024: 13 · 2023: 25 · 2022: 19 · 2021: 23 · 2020: 24 · 2019: 18 · 2018: 20 · 2017: 13 · 2016: 19 · 2015: 20 · 2014: 23 · 2013: 14 · 2012: 21
- FWCI
- 10.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- depression assessment, PHQ-9, telephone administration, self-administered questionnaire, primary care, test-retest reliability, internal consistency, measurement agreement
- MeSH terms
- Adult, Aged, Depression, Female, Health Status Indicators, Humans, Male, Middle Aged, Primary Health Care, Surveys and Questionnaires, Telephone, Reproducibility of Results
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