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PHQ-9 and PHQ-2 for Screening Depression in Chinese Rural Elderly.

Zi-Wei Liu1, Yu Yu1, Mi Hu1

  • 1Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.

Plos One
|March 16, 2016
PubMed
Summary

This study identified optimal cut-off scores for the Patient Health Questionnaire (PHQ-9) and Patient Health Questionnaire (PHQ-2) depression screening tools in Chinese rural elderly. Recommended scores are 8 for PHQ-9 and 3 for PHQ-2.

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Area of Science:

  • Geriatric Psychiatry
  • Mental Health Screening
  • Epidemiology

Background:

  • Depression is a significant concern in the elderly population, particularly in rural areas.
  • Accurate screening tools are crucial for early detection and intervention in geriatric mental health.
  • The Patient Health Questionnaire (PHQ-9 and PHQ-2) are widely used but require validation in specific demographic groups.

Purpose of the Study:

  • To determine optimal cut-off scores for the 9-item Patient Health Questionnaire (PHQ-9) and 2-item Patient Health Questionnaire (PHQ-2) for depression screening.
  • To evaluate the diagnostic accuracy of PHQ-9 and PHQ-2 in a Chinese rural elderly population.
  • To establish evidence-based screening parameters for depression in this vulnerable demographic.

Main Methods:

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  • A cross-sectional study involving 839 rural residents aged 60+ in Liuyang County.
  • Depression was assessed using the PHQ-9, with diagnosis of Major Depressive Disorder (MDD) confirmed by the Structured Clinical Interview for DSM Disorders (SCID-I).
  • Statistical analyses included sensitivity, specificity, predictive values, likelihood ratios, Youden's index, and receiver operating characteristic (ROC) curve analysis.

    • Main Results:

    • The PHQ-9 demonstrated high internal consistency (Cronbach's alpha=0.82). A cut-off score of 8 yielded the highest Youden's index (0.85), with 0.97 sensitivity and 0.89 specificity (AUC=0.97).
    • The PHQ-2 also showed good reliability (Cronbach's alpha=0.76). A cut-off score of 3 achieved a Youden's index of 0.79, with 0.90 sensitivity and 0.90 specificity (AUC=0.94).
    • Both instruments exhibited strong performance in identifying depression within the study population.

    Conclusions:

    • The PHQ-9 and PHQ-2 are validated and reliable instruments for screening depression among the rural elderly in China.
    • Recommended cut-off scores are 8 for the PHQ-9 and 3 for the PHQ-2.
    • These findings support the use of these tools for effective depression screening in this specific population, facilitating timely mental healthcare.