Shortening Self-report Mental Health Symptom Measures through Optimal Test Assembly Methods: Development and Validation of the Patient Health Questionnaire-Depression-4

Details

• Alternative Title:
  Depress Anxiety
• Personal Author:
  Ishihara, Miyabi ; Harel, Daphna ; Levis, Brooke ; Levis, Alexander W. ; Riehm, Kira E. ; Saadat, Nazanin ; Azar, Marleine ; Rice, Danielle B. ; Sanchez, Tatiana A. ; Chiovitti, Matthew J. ; Cuijpers, Pim ; Gilbody, Simon ; Ioannidis, John P.A. ; Kloda, Lorie A. ; McMillan, Dean ; Patten, Scott B. ; Shrier, Ian ; Arroll, Bruce ; Bombardier, Charles H. ; Butterworth, Peter ; Carter, Gregory ; Clover, Kerrie ; Conwell, Yeates ; Goodyear-Smith, Felicity ; Greeno, Catherine G. ; Hambridge, John ; Harrison, Patricia A. ; Hudson, Marie ; Jetté, Nathalie ; Kiely, Kim M. ; McGuire, Anthony ; Pence, Brian W. ; Rooney, Alasdair G. ; Sidebottom, Abbey ; Simning, Adam ; Turner, Alyna ; White, Jennifer ; Whooley, Mary A. ; Winkley, Kirsty ; Benedetti, Andrea ; Thombs, Brett D.
• Description:
  Background:
  
  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.
  
  Methods:
  
  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 1 and 8 items, including and excluding the 9th item. The final short form was selected based on pre-specified validity, reliability, and diagnostic accuracy criteria.
  
  Results:
  
  A 4-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).
  
  Conclusion:
  
  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 used to shorten patient-reported outcome measures based on objective, pre-specified criteria, further studies are required to validate this general procedure for broader use in health research. Furthermore, due to unexamined heterogeneity, there is a need to replicate the results of this study in different patient populations.
  
  
• Subjects:
  Article Depression Depressive Disorder Factor Analysis, Statistical Female Humans Male Mental Health Middle Aged Patient Health Questionnaire Patient Outcome Assessment Psychometrics Reproducibility Of Results Self Report Sensitivity And Specificity

  More +
• Source:
  Depress Anxiety. 36(1):82-92
• Pubmed ID:
  30238571
• Pubmed Central ID:
  PMC6321766
• Document Type:
  Journal Article
• Funding:
  R36 HS018246/HS/AHRQ HHS/United States ; R34 MH072925/MH/NIMH NIH HHS/United States ; R24MH071604/MH/NIMH NIH HHS/United States ; R01 MH069666/MH/NIMH NIH HHS/United States ; K02 MH65919/MH/NIMH NIH HHS/United States ; R49 CE002093/CC/CDC HHS/United States ; R01 HL079235/HL/NHLBI NIH HHS/United States ; P30 DK50456/MH/NIMH NIH HHS/United States ; R49 CE002093/CE/NCIPC CDC HHS/United States ; R34 MH084673/MH/NIMH NIH HHS/United States ; P30 DK050456/DK/NIDDK NIH HHS/United States ; RP-PG-0606-1142/Department of Health/United Kingdom ; T32 GM007356/GM/NIGMS NIH HHS/United States ; TL1 RR024135/RR/NCRR NIH HHS/United States ; R01 HL079235/Department of Veterans Epidemiology Merit Review Program, the Department of Veterans Affairs Health Services Research and Development service, the National Heart Lung and Blood Institute/International ; R36 HS018246/Agency for Healthcare Research and Quality/International ; K02 MH065919/MH/NIMH NIH HHS/United States ; FRN 83518/CIHR/Canada ; R24 MH071604/MH/NIMH NIH HHS/United States ; R34MH084673/MH/NIMH NIH HHS/United States ; R24 MH56858/MH/NIMH NIH HHS/United States ; KRS-134297/CIHR/Canada ; MR/J000914/1/Medical Research Council/United Kingdom ; T32 GM07356/GF/NIH HHS/United States ; R40MC07840/U.S. Department of Health and Human Services, Health Resources and Services Administration/International
• Volume:
  36
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2ecd6747925ade8e5481a33952cfa3e50da6c67e54916a67ee727c1dfc345963
• Download URL:
  https://stacks.cdc.gov/view/cdc/61821/cdc_61821_DS1.pdf
• File Type:
  [PDF - 401.81 KB ]