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A Comparison of Depression and Mental Distress Indicators, Rhode Island Behavioral Risk Factor Surveillance System, 2006
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Feb 15 2011
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Source: Prev Chronic Dis. 8(2).
[PDF-697.45 KB]
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Alternative Title:Prev Chronic Dis
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Description:Introduction
Depression is a public health concern that warrants accurate population estimates. The patient health questionnaire 8 (PHQ-8) offers high sensitivity and specificity for assessing depression but is time-consuming to administer, answer, and score. We sought to determine whether 1 of 3 simpler instruments — the shorter PHQ-2 or 2 single questions from the health-related quality of life (HRQOL) module of the Behavioral Risk Factor Surveillance System (BRFSS) — could offer accuracy comparable to the PHQ-8.
Methods
We compared the depression and mental distress indicators of 2006 Rhode Island BRFSS data by using 4 types of analyses: 1) sensitivity and specificity estimates, 2) prevalence estimates, 3) multivariable logistic regression modeling of the relationship between each of the 4 indicators and 11 demographic and health risk variables, and 4) geographic distribution of prevalence.
Results
Compared with the PHQ-8, the 3 other measures have high levels of specificity but lower sensitivity. Depression prevalence estimates ranged from 8.6% to 10.3%. The adjusted odds ratios from logistic regression modeling were consistent. Each of the indicators was significantly associated with low income, being unable to work, current smoking, and having a disability.
Conclusion
The PHQ-8 indicator is the most sensitive and specific and can assess depression severity. The HRQOL and PHQ-2 indicators are adequate to obtain population prevalence estimates if questionnaire length is limited.
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