Validation of the Patient Health Questionnaire–9 and Patient Health Questionnaire–2 in the General Korean Population
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Objective The Patient Health Questionnaire–9 (PHQ-9) and PHQ-2 have not been validated in the general Korean population. This study aimed to validate and identify the optimal cutoff scores of the PHQ-9 and PHQ-2 in screening for major depression in the general Korean population.Methods We used data from 6,022 participants of the Korean Epidemiological Catchment Area Study for Psychiatric Disorders in 2011. Major depression was diagnosed according to the Korean Composite International Diagnostic Interview. Validity, reliability, and receiver operating characteristic curve analyses were performed using the results of the PHQ-9 and Euro Quality of life-5 dimension (EQ-5d).Results Of the 6,022 participants, 150 were diagnosed with major depression (2.5%). Both PHQ-9 and PHQ-2 demonstrated relatively high reliability and their scores were highly correlated with the “anxiety/depression” score of the EQ-5d. The optimal cutoff score of the PHQ-9 was 5, with a sensitivity of 89.9%, specificity of 84.1%, positive predictive value (PPV) of 12.6%, negative predictive value (NPV) of 99.7%, positive likelihood ratio (LR+) of 5.6, and negative likelihood ratio (LR-) of 0.12. The optimal cutoff score of the PHQ-2 was 2, with a sensitivity of 85.3%, specificity of 83.2%, PPV of 11.6%, NPV of 99.5%, LR+ of 5.1, and LR- of 0.18.Conclusion The PHQ-9 and PHQ-2 are valid tools for screening major depression in the general Korean population, with suggested cutoff values of 5 and 2 points, respectively.
Abstract
Objective The Patient Health Questionnaire–9 (PHQ-9) and PHQ-2 have not been validated in the general Korean population. This study aimed to validate and identify the optimal cutoff scores of the PHQ-9 and PHQ-2 in screening for major depression in the general Korean population.Methods We used data from 6,022 participants of the Korean Epidemiological Catchment Area Study for Psychiatric Disorders in 2011. Major depression was diagnosed according to the Korean Composite International Diagnostic Interview. Validity, reliability, and receiver operating characteristic curve analyses were performed using the results of the PHQ-9 and Euro Quality of life-5 dimension (EQ-5d).Results Of the 6,022 participants, 150 were diagnosed with major depression (2.5%). Both PHQ-9 and PHQ-2 demonstrated relatively high reliability and their scores were highly correlated with the “anxiety/depression” score of the EQ-5d. The optimal cutoff score of the PHQ-9 was 5, with a sensitivity of 89.9%, specificity of 84.1%, positive predictive value (PPV) of 12.6%, negative predictive value (NPV) of 99.7%, positive likelihood ratio (LR+) of 5.6, and negative likelihood ratio (LR-) of 0.12. The optimal cutoff score of the PHQ-2 was 2, with a sensitivity of 85.3%, specificity of 83.2%, PPV of 11.6%, NPV of 99.5%, LR+ of 5.1, and LR- of 0.18.Conclusion The PHQ-9 and PHQ-2 are valid tools for screening major depression in the general Korean population, with suggested cutoff values of 5 and 2 points, respectively.
참고문헌 (47)
- "Depression and other common mental disorders: global health estimates"[URL]
- Lépine JP, "The increasing burden of depression", Neuropsychiatr Dis Treat, 7(Suppl 1), pp.3~7 (2011)
- 조맹제, "Prevalence and Correlates of DSM-IV Mental Disorders in South Korean Adults: The Korean Epidemiologic Catchment Area Study 2011", PSYCHIATRY INVESTIGATION, 12(2), pp.164~170 (2015), 대한신경정신의학회[DOI]
- Hasin DS, "Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States", JAMA Psychiatry, 75, pp.336~346 (2018)
- Gutiérrez-Rojas L, "Prevalence and correlates of major depressive disorder : a systematic review", Braz J Psychiatry, 42, pp.657~672 (2020)
- "Annual report on the cause of death statistics, 2020"[URL]
- Cavanagh JT, "Psychological autopsy studies of suicide : a systematic review", Psychol Med, 33, pp.395~405 (2003)
- Henriksson MM, "Mental disorders and comorbidity in suicide", Am J Psychiatry, 150, pp.935~940 (1993)
- Mann JJ, "Suicide prevention strategies : a systematic review", JAMA, 294, pp.2064~2074 (2005)
- Spitzer RL, "Validation and utility of a self-report version of PRIME-MD : the PHQ primary care study", JAMA, 282, pp.1737~1744 (1999)
- Kroenke K, "Enhancing the clinical utility of depression screening", CMAJ, 184, pp.281~282 (2012)
- Kroenke K, "The Patient Health Questionnaire-2 : validity of a two-item depression screener", Med Care, 41, pp.1284~1292 (2003)
- Costantini L, "Screening for depression in primary care with Patient Health Questionnaire-9(PHQ-9) : a systematic review", J Affect Disord, 279, pp.473~483 (2021)
- Manea L, "Identifying depression with the PHQ-2 : a diagnostic meta-analysis", J Affect Disord, 203, pp.382~395 (2016)
- Han C, "Validation of the Patient Health Questionnaire-9 Korean version in the elderly population : the Ansan Geriatric study", Compr Psychiatry, 49, pp.218~223 (2008)
- Seo JG, "Validation of the Patient Health Questionnaire-9(PHQ-9)and PHQ-2 in patients with migraine", J Headache Pain, 16, pp.65~ (2015)
- 신철민, "Comparison of the Usefulness of the PHQ-8 and PHQ-9 for Screening for Major Depressive Disorder: Analysis of Psychiatric Outpatient Data", PSYCHIATRY INVESTIGATION, 16(4), pp.300~305 (2019), 대한신경정신의학회[DOI]
- Shin C, "Normative data and psychometric properties of the Patient Health Questionnaire-9 in a nationally representative Korean population", BMC Psychiatry, 20, pp.194~ (2020)
- The epidemiological survey of mental disorders in Korea, "Ministry of Health and Welfare", Ministry of Health and Welfare, ~ (2011)
- "2010 population and housing census"[URL]
- Robins LN, "The composite international diagnostic interview : an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures", Arch Gen Psychiatry, 45, pp.1069~1077 (1988)
- 조맹제, "한국어판 Composite International Diagnostic Interview(K-CIDI)의 개발", 신경정신의학, 41(1) (2002), 대한신경정신의학회
- World Health Organization, "Procedures for the development of new language versions of the WHO Composite International Diagnostic Interview (WHO-CIDI)", World Health Organization, ~ (1998)
- Kroenke K, "The PHQ-9 : validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM-IV-TR)" (2010), American Psychiatric Publishing
- 박승진, "한글판 우울증 선별도구(Patient Health Questionnaire-9, PHQ-9)의 신뢰도와 타당도", 대한불안의학회지, 6(2), pp.119~124 (2010), 대한불안의학회
- Rabin R, "EQ-SD : a measure of health status from the EuroQol Group", Ann Med, 33, pp.337~343 (2001)
- 오현숙, "한국인의 연령대에 따른 건강관련 삶의 질(EQ-5D)에 대한주요 요인 분석", 한국데이터정보과학회지, 28(3), pp.573~584 (2017), 한국데이터정보과학회[DOI]
- Kim MH, "Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases", Qual Life Res, 14, pp.1401~1406 (2005)
- Nunnally JC, "Psychometric theory" (1978), McGraw-Hill
- Yu X, "The Patient Health Questionnaire-9 for measuring depressive symptoms among the general population in Hong Kong", Compr Psychiatry, 53, pp.95~102 (2012)
- Kocalevent RD, "Standardization of the depression screener Patient Health Questionnaire(PHQ-9)in the general population", Gen Hosp Psychiatry, 35, pp.551~555 (2013)
- Yu X, "Screening for depression with the Patient Health Questionnaire-2(PHQ-2)among the general population in Hong Kong", J Affect Disord, 134, pp.444~447 (2011)
- Wang W, "Reliability and validity of the Chinese version of the Patient Health Questionnaire(PHQ-9)in the general population", Gen Hosp Psychiatry, 36, pp.539~544 (2014)
- Inagaki M, "Validity of the Patient Health Questionnaire(PHQ)-9 and PHQ-2 in general internal medicine primary care at a Japanese rural hospital : a cross-sectional study", Gen Hosp Psychiatry, 35, pp.592~597 (2013)
- Sung SC, "Screening for major and minor depression in a multiethnic sample of Asian primary care patients : a comparison of the nine-item Patient Health Questionnaire(PHQ-9)and the 16-item Quick Inventory of Depressive Symptomatology–Self-Report(QIDS-SR16)", Asia Pac Psychiatry, 5, pp.249~258 (2013)
- Jang Y, "Attitudes toward mental health services : age-group differences in Korean American adults", Aging Ment Health, 13, pp.127~134 (2009)
- Abdullah T, "Mental illness stigma and ethnocultural beliefs, values, and norms : an integrative review", Clin Psychol Rev, 31, pp.934~948 (2011)
- Park JE, "Impact of stigma on use of mental health services by elderly Koreans", Soc Psychiatry Psychiatr Epidemiol, 50, pp.757~766 (2015)
- Manea L, "Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire(PHQ-9) : a meta-analysis", CMAJ, 184, pp.E191~E196 (2012)
- Kiely KM, "Validation of four measures of mental health against depression and generalized anxiety in a community based sample", Psychiatry Res, 225, pp.291~298 (2015)
- Beard C, "Validation of the PHQ-9 in a psychiatric sample", J Affect Disord, 193, pp.267~273 (2016)
- Liu SI, "Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan", Compr Psychiatry, 52, pp.96~101 (2011)
- Arroll B, "Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population", Ann Fam Med, 8, pp.348~353 (2010)
- Mischlinger J, "A common trap of diagnostic tests : disease prevalence and positive predictive value", Wien KlinWochenschr, 129, pp.583~584 (2017)
- Kent P, "Interpretation of dichotomous outcomes : sensitivity, specificity, likelihood ratios, and pre-test and post-test probability", J Physiother, 62, pp.231~233 (2016)
- Haro JM, "Concordance of the Composite International Diagnostic Interview Version 3. 0(CIDI 3. 0)with standardized clinical assessments in the WHO World Mental Health surveys", Int J Methods Psychiatr Res, 15, pp.167~180 (2006)