The validity and reliability of the PHQ-9 on screening of depression in neurology: a cross sectional study
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BACKGROUND: This study aimed to explore the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) on screening of depression among patients with neurological disorders, and to explore factors influencing such patients. METHODS: In this study, 277 subjects who were admitted to the department of neurology of our hospital due to different neurological disorders completed the PHQ-9 questionnaire. The Mini-International Neuropsychiatric Interview (MINI) and Hamilton Rating Scale for Depression (HAMD) were employed to evaluate the depressive symptoms of patients who completed the PHQ-9 questionnaire. The internal consistency, criterion validity, structural validity, and optimal cut-off values of PHQ-9 were evaluated, and the consistency assessment was conducted between the depression severity as assessed by PHQ-9, HAMD and MINI. Logistic regression analysis was used to calculate the risk factors of depression. RESULTS: The Cronbach's α coefficient of the PHQ-9 was 0.839. The Pearson's correlation coefficient among the 9 items of the PHQ-9 scale was 0.160 ~ 0.578 (P < 0.01), and the Pearson's correlation coefficient between each item and the total score was at the range of 0.608 ~ 0.773. Taking the results of MINI as the gold standard, the area under the receiver operating characteristic (ROC) curve of the PHQ-9 results for all the subjects (n = 277) was 0.898 (95% confidence interval (CI): 0.859 ~ 0.937, P < 0.01). When the cut-off score was equal to 5, the values of sensitivity, specificity, and the Youden's index were 91.2, 76.6%, and 0.678, respectively. Multivariate logistic regression analysis showed that the influence of unemployment on the occurrence of depression was statistically significant (P = 0.027, OR = 3.080, 95%CI: 1.133 ~ 8.374). CONCLUSIONS: The application of PHQ-9 for screening of depression among Chinese patients with neurological disorders showed a good reliability and validity.
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The PHQ-9 has demonstrated high internal consistency (Cronbach α=.89) and excellent test-retest reliability (r=0.84).
“The PHQ-9 has demonstrated high internal consistency, with a Cronbach α of .89, and excellent test-retest reliability, with a correlation coefficient of 0.84 [28].”
From Predictors and Correlates of Depression and Anxiety Symptom Trajectories in a Large Digital Mental Health Provider: Retrospective Analysis of Data From Rula Health (2025) · cites this paper as [28]
The Discussion reports high internal consistency for the PHQ-9, but gives Cronbach’s α as 0.839, not 0.89. The Results > Reliability section reports item correlations; neither it nor the passages found for test-retest reliability report a test-retest coefficient of 0.84. No page numbers are provided in our copy. (LLM, conf=0.88)
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- Authors
- Sun, Y., Kong, Z., Song, Y., Liu, J., & Wang, X.
- Affiliations
- Peking University (CN)
- Corresponding author
- Song, Yuqing
- Liu, Jing
- Wang, Xilin
- Venue
- BMC Psychiatry
- Published
- 2022-02-09
- Volume
- 22
- Issue
- 1
- Pages
- 98-98
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC8827244
- OpenAlex
- W4210925784
- Cited by
- 131
- References
- 46
- Citations by year
- 2026: 32 · 2025: 51 · 2024: 26 · 2023: 19 · 2022: 3
- FWCI
- 22.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Education › Health Education and Validation
- Keywords
- PHQ-9, depression screening, neurological disorders, psychometric validation, internal consistency, cut-off values, unemployment, risk factors for depression, Chinese patients
- MeSH terms
- Patient Health Questionnaire, Cross-Sectional Studies, Depression, Humans, Nervous System Diseases, Neurology, Surveys and Questionnaires, Reproducibility of Results
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