Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population
Objectives The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity a...
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| Format: | Article |
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BMJ Publishing Group
2023-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/9/e076193.full |
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| author | David Villarreal-Zegarra Juan Carlos Bazo-Alvarez Juan Barrera-Begazo Sharlyn Otazú-Alfaro Nikol Mayo-Puchoc Jeff Huarcaya-Victoria |
| author_facet | David Villarreal-Zegarra Juan Carlos Bazo-Alvarez Juan Barrera-Begazo Sharlyn Otazú-Alfaro Nikol Mayo-Puchoc Jeff Huarcaya-Victoria |
| author_sort | David Villarreal-Zegarra |
| collection | DOAJ |
| description | Objectives The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population.Design Our study has a cross-sectional design.Setting Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1).Participants The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety.Results The PHQ-9’s≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability.Conclusions The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version. |
| format | Article |
| id | doaj-art-01175cf5b0de472da7e3b3195861c5da |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-01175cf5b0de472da7e3b3195861c5da2025-02-02T03:20:10ZengBMJ Publishing GroupBMJ Open2044-60552023-09-0113910.1136/bmjopen-2023-076193Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital populationDavid Villarreal-Zegarra0Juan Carlos Bazo-Alvarez1Juan Barrera-Begazo2Sharlyn Otazú-Alfaro3Nikol Mayo-Puchoc4Jeff Huarcaya-Victoria54 Instituto Peruano de Orientación Psicológica, Lima, PeruResearch Department of Primary Care and Population Health, University College London, London, UKInstituto Peruano de Orientación Psicológica, Lima, PeruInstituto Peruano de Orientación Psicológica, Lima, PeruInstituto Peruano de Orientación Psicológica, Lima, PeruEscuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, PeruObjectives The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population.Design Our study has a cross-sectional design.Setting Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1).Participants The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety.Results The PHQ-9’s≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability.Conclusions The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version.https://bmjopen.bmj.com/content/13/9/e076193.full |
| spellingShingle | David Villarreal-Zegarra Juan Carlos Bazo-Alvarez Juan Barrera-Begazo Sharlyn Otazú-Alfaro Nikol Mayo-Puchoc Jeff Huarcaya-Victoria Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population BMJ Open |
| title | Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population |
| title_full | Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population |
| title_fullStr | Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population |
| title_full_unstemmed | Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population |
| title_short | Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population |
| title_sort | sensitivity and specificity of the patient health questionnaire phq 9 phq 8 phq 2 and general anxiety disorder scale gad 7 gad 2 for depression and anxiety diagnosis a cross sectional study in a peruvian hospital population |
| url | https://bmjopen.bmj.com/content/13/9/e076193.full |
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