Validation and calibration of the patient health questionnaire (PHQ-9) in Argentina

Background: The Patient Health Questionnaire-9 (PHQ-9) is a brief tool to assess the presence and severity of depressive symptoms. This study aimed to validate and calibrate the PHQ-9 to determine appropriate cut-off points for different degrees of severity of depression in Argentina. Methods: We conducted a cross-sectional study on an intentional sample of adult ambulatory care patients with different degrees of severity of depression. All patients who completed the PHQ-9 were further interviewed by a trained clinician with the Mini International Neuropsychiatric Interview (MINI) and the Beck Depression Inventory-II (BDI-II). Reliability and validity tests, including receiver operating curve analysis, were performed. Results: One hundred sixty-nine patients were recruited with a mean age of 47.4 years (SD = 14.8), of whom 102 were females (60.4%). The local PHQ-9 had high internal consistency (Cronbach's alpha = 0.87) and satisfactory convergent validity with the BDI-II scale [Pearson's correlation = 0.88 (p < 0.01)]. For the diagnosis of Major Depressive Episode (MDE) according to the MINI, a PHQ-9 ≥ 8 was the optimal cut-off point found (sensitivity 88.2%, specificity 86.6%, PPV 90.91%). The local version of PHQ-9 showed good ability to discriminate among depression severity categories according to the BDI-II scale. The best cut off points were 6-8 for mild cases, 9-14 for moderate and 15 or more for severe depressive symptoms respectively. Conclusions: The Argentine version of the PHQ-9 questionnaire has shown acceptable validity and reliability for both screening and severity assessment of depressive symptoms. Fil: Urtasun, María. Instituto de Efectividad Clínica y Sanitaria; Argentina. Universidad de Alcalá; España Fil: Daray, Federico Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; Argentina Fil: Teti, Germán Leandro. Gobierno de la Ciudad Autónoma de Buenos Aires. Hospital Neuropsiquiátrico Braulio Aurelio Moyano; Argentina Fil: Coppolillo, Fernando Enrique. Universidad de Buenos Aires. Facultad de Medicina; Argentina Fil: Herlax, Gabriela. Universidad de Buenos Aires. Facultad de Medicina; Argentina Fil: Saba, Guillermo. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Araya, Ricardo. London School of Hygiene and Tropical Medicine; Reino Unido Fil: Irazola, Vilma. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina