Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina

DARAY, FEDERICO MANUEL; HERLAX, GABRIELA; ARAYA, RICARDO; TETI, GERMÁN LEANDRO; SABA, GUILLERMO; IRAZOLA, VILMA; URTASUN, MARÍA; COPPOLILLO, FERNANDO; RUBINSTEIN, ADOLFO

BMC PSYCHIATRY

BIOMED CENTRAL LTD

Año: 2019 vol. 19

1471-244X

Background: The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. Methods: We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. Results: One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach´s alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson´s correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6-8 for mild cases, 9-14 for moderate and 15 or more for severe depressive symptoms respectively. Conclusions: The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms.