Translating measurement into practice: Brazilian norms for depressive symptom assessment with the Patient Health Questionnaire (PHQ-9)

Objectives: To provide practical norms for measuring depressive symptoms with the Patient Health Questionnaire 9 (PHQ-9) in Brazil through a state-of-the-art psychometrics analysis. Methods: We used a large representative dataset from the 2019 Brazilian National Health Survey (Pesquisa Nacional de Saúde - 2019), which included 90,846 Brazilian citizens. To assess scale structure, we assessed a unidimensional model using confirmatory factor analysis. Item response theory was used to characterize the distribution of depressive symptoms. Summed- and mean-based PHQ-9 scores were then linked using item response theory-based scores in generalized additive models. Finally, percentiles, T scores, and a newly developed score, called the decimal score (D score), were generated to describe PHQ-9 norms for the Brazilian population. Results: Confirmatory factor analysis revealed a good fit to the unidimensional model, being invariant to age and sex. Item response theory captured item-level information about the latent trait (reliable from 1 to 3 SDs above the mean). Brazilian norms were presented using summed scores, T scores, and D scores. Conclusion: This is the first study to determine Brazilian norms for the PHQ-9 among a large representative sample using robust psychometric tools. More precise PHQ-9 scores are now available and may be widely used in primary and specialized clinical care settings.

A study on the effect of measurement-based care using Patient Health Questionnaire Depression Scale (PHQ-9)on patients with depression / 预防医学

Objective Thisstudyaimstoexploretheeffectofmeasurement-basedcareusingPatientHealthQuestionnaire DepressionScale(PHQ-9)onpatientswithonsetdepression.Methods Atotalof120patientswithonsetdepressionwere randomly assigned to the test group and control group.The test group was treated with measurement-based care using PHQ-9 and the control group maintains normal treatment.We assessed the HAMD1 7 score and social function of all patients on acute phase (after two month treatment),middle phase (after six month treatment)and long phase (after one year treatment).Results ThemeanHAMD17scoreofpatientsinthetestgroupwaslowerthanthecontrolgroupat6monthand 1 2month(P<0.01 ),and the difference of the reduced score at 1 2month was significant (P<0.01 ).The patients has better social function score and lower recurrence rate in the test group than that of the control group (P <0.05 ). Conclusion Theonsetdepressivepatientwhotreatedwithmeasurement-basedcareusingPHQ-9showsbettereffect and social function compared with those with normal outpatient treatment.

Rating Scales for Measurement-Based Clinical Practice of Depression / 대한정신약물학회지

The goal of treatment for depression is remission, but many patients do not achieve complete remission, and few reach sustained remission. This article aims to introduce depression rating scales and to encourage using these scales for objective and accurate assessment of depressive symptoms. There are various depression rating scales which can be categorized into the observer-rated scales and the self-report scales; The observer-rated scales include Hamilton Depression Rating Scale, Montgomery-Asberg Depression Rating Scale and the self-report scales include Beck Depression Inventory (BDI), BDI-II, Center for Epidemiologic Studies Depression Scale, Patient Health Questionnaire-9 (PHQ-9), Geriatric Depression Scale (GDS), GDS-15. Validated and standardized self-report scales such as BDI-II, PHQ-9 are cost-effective and useful when assessing many patients in limited time in daily clinic. Assessment of anxiety, somatic symptoms, drug adherence and using Clinical Global Impression Scale might be useful for the improvement of the depression care in the clinic.