Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4

Depression and Anxiety
Miyabi IshiharaBrett D Thombs

Abstract

The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria. Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit. Optimal test assembly (OTA) methods identified a maximally precise short form for each possible length between one and eight items, including and excluding the ninth item. The final short form was selected based on prespecified validity, reliability, and diagnostic accuracy criteria. A four-item short form of the PHQ (PHQ-Dep-4) was selected. The PHQ-Dep-4 had a Cronbach's alpha of 0.805. Sensitivity and specificity of the PHQ-Dep-4 were 0.788 and 0.837, respectively, and were statistically equivalent to the PHQ-9 (sensitivity = 0.761, specificity = 0.866). The correlation of total scores with the full PHQ-9 was high (r = 0.919). The PHQ-Dep-4 is a valid short form with minimal loss of information of scores when compared to the full-length PHQ-9. Although OTA methods have been...Continue Reading

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Citations

Sep 19, 2019·Community Mental Health Journal·Zhiyong HuangFabrice Kämpfen
Feb 6, 2020·Asia-Pacific Psychiatry : Official Journal of the Pacific Rim College of Psychiatrists·Doris Y P LeungAlice Yuen Loke
May 18, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·S LiM S M Ip
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Oct 22, 2020·Current Medical Research and Opinion·Wei ZhouChen Dong
Feb 23, 2021·Psychological Medicine·Felix FischerUNKNOWN Depression Screening Data (DEPRESSD) PHQ Collaboration
Mar 23, 2021·Internet Interventions : the Application of Information Technology in Mental and Behavioural Health·Eva HeimEdith Van't Hof
Jul 3, 2021·International Journal of Environmental Research and Public Health·Ahmed WaqasAtif Rahman

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