Validity of an interviewer-administered patient health questionnaire-9 to screen for depression in HIV-infected patients in Cameroon

Journal of Affective Disorders
Brian W PencePeter M Ndumbe

Abstract

In high-income countries, depression is prevalent in HIV patients and is associated with lower medication adherence and clinical outcomes. Emerging evidence from low-income countries supports similar relationships. Yet little research has validated rapid depression screening tools integrated into routine HIV clinical care. Using qualitative methods, we adapted the Patient Health Questionnaire-9 (PHQ-9) depression screening instrument for use with Cameroonian patients. We then conducted a cross-sectional validity study comparing an interviewer-administered PHQ-9 to the reference standard Composite International Diagnostic Interview in 400 patients on antiretroviral therapy attending a regional HIV treatment center in Bamenda, Cameroon. The prevalence of major depressive disorder (MDD) in the past month was 3% (n=11 cases). Using a standard cutoff score of ≥10 as a positive depression screen, the PHQ-9 had estimated sensitivity of 27% (95% confidence interval: 6-61%) and specificity of 94% (91-96%), corresponding to positive and negative likelihood ratios of 4.5 and 0.8. There was little evidence of variation in specificity by gender, number of HIV symptoms, or result of a dementia screen. The low prevalence of MDD yielded very i...Continue Reading

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Citations

Mar 19, 2016·The International Journal on Drug Policy·Kathryn E LancasterWilliam C Miller
Aug 1, 2015·Journal of Affective Disorders·Charlotte HanlonAbebaw Fekadu
Nov 22, 2018·BJOG : an International Journal of Obstetrics and Gynaecology·D M KoppJ Wilkinson
Feb 23, 2020·AIDS and Behavior·Rebecca B HershowVivian F Go
Mar 21, 2018·International Journal of Mental Health and Addiction·Sarah A MacLeanWilliam C Miller
Jun 27, 2019·The International Journal of Social Psychiatry·Anna AbelsonStefan D Baral

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