Antonio Cano-Vindel1, Roger Muñoz-Navarro2, Leonardo Adrián Medrano3, Paloma Ruiz-Rodríguez4, César González-Blanch5, María Dolores Gómez-Castillo6, Antonio Capafons7, Fernando Chacón8, Francisco Santolaya9. 1. Department of Basic Psychology, Faculty of Psychology, University Complutense of Madrid, Madrid, Spain. Electronic address: canovindel@psi.ucm.es. 2. Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain. 3. Faculty of Psychology, University Siglo 21, Córdoba, Argentina. 4. Mental Health Centre, University Hospital "Marqués de Valdecilla"- IDIVAL, Santander, Spain. 5. Castilla La Nueva Primary Care Center, Health Service of Madrid, Madrid, Spain. 6. Mental Health Centre, "Complejo Hospitalario of Albacete", Albacete, Spain; Spanish Council of Psychologists, Madrid, Spain. 7. Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, University of Valencia, Valencia, Spain. 8. Department of Social Psychology, Faculty of Psychology, University Complutense of Madrid, Madrid, Spain; Spanish Council of Psychologists, Madrid, Spain. 9. Malva-Rosa Mental Health Service, Valencia, Spain; Spanish Council of Psychologists, Madrid, Spain.
Abstract
BACKGROUND: The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report consisting of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). The aim of the present study is to determine the psychometric properties of a computerized version of the PHQ-4 used to detect emotional disorders (anxiety and depression) in the primary care setting. METHOD: A total of 1052 patients with suspected anxiety, depression, or somatic symptoms were recruited from 28 primary care centres participating in the PsicAP trial and completed the full version of the computerized PHQ. In addition, 178 of these patients also underwent in clinical interviews as a gold standard. RESULTS: Confirmatory factor analyses showed very good fit indices for a two-factor solution. This model was structurally invariant among the various age and gender groups and internal consistency was acceptable (PHQ-4; α = .83, PHQ-2; α = .86, and GAD-2; α = .76). The best cut-off points to obtain high sensitivity values was 3, on both the PHQ-2 (major depressive disorder) and the GAD-2 (generalized anxiety disorder). The criterion validity (sensitivity and specificity) for the PHQ-2 were .90 and .61 and for the GAD-2, .88 and 0.61. LIMITATIONS: The study was not designed as a prevalence study. Therefore, does not contain information on patients whose general practitioners do not consider them to suffer emotional disorders. CONCLUSION: This is the first study to provide evidence for the reliability and validity of a computerized version of the PHQ-4. This computerized tool can be used to detect depression and anxiety in a primary care setting.
BACKGROUND: The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report consisting of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). The aim of the present study is to determine the psychometric properties of a computerized version of the PHQ-4 used to detect emotional disorders (anxiety and depression) in the primary care setting. METHOD: A total of 1052 patients with suspected anxiety, depression, or somatic symptoms were recruited from 28 primary care centres participating in the PsicAP trial and completed the full version of the computerized PHQ. In addition, 178 of these patients also underwent in clinical interviews as a gold standard. RESULTS: Confirmatory factor analyses showed very good fit indices for a two-factor solution. This model was structurally invariant among the various age and gender groups and internal consistency was acceptable (PHQ-4; α = .83, PHQ-2; α = .86, and GAD-2; α = .76). The best cut-off points to obtain high sensitivity values was 3, on both the PHQ-2 (major depressive disorder) and the GAD-2 (generalized anxiety disorder). The criterion validity (sensitivity and specificity) for the PHQ-2 were .90 and .61 and for the GAD-2, .88 and 0.61. LIMITATIONS: The study was not designed as a prevalence study. Therefore, does not contain information on patients whose general practitioners do not consider them to suffer emotional disorders. CONCLUSION: This is the first study to provide evidence for the reliability and validity of a computerized version of the PHQ-4. This computerized tool can be used to detect depression and anxiety in a primary care setting.
Keywords:
Emotional disorders; Factor structure analyses; General Anxiety Disorder-2; General anxiety disorder; Major depression; Patient Health Questionnaire-2; Patient Health Questionnaire-4; Primary care; Psychometric properties
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