Kumiko Muramatsu1, Hitoshi Miyaoka2, Kunitoshi Kamijima3, Yoshiyuki Muramatsu4, Yutaka Tanaka5, Michio Hosaka6, Yusuke Miwa7, Katsuya Fuse8, Fumitoshi Yoshimine9, Ichiro Mashima10, Natsue Shimizu11, Hiroto Ito12, Eiji Shimizu13. 1. Department of Clinical Psychology, Graduate School of Niigata Seiryo University, Japan. Electronic address: muramatu@n-seiryo.ac.jp. 2. Department of Psychiatry, Kitasato University School of Medicine, Japan. 3. Department of Medicine, Showa University School of Medicine, Japan. 4. School of Health Science, Niigata University, Japan. 5. Niigata University Graduate School of Medicine and Dental Sciences, Japan. 6. Katsuyama Medical Clinic, Japan. 7. Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Japan. 8. Koide City Hospital, Japan. 9. Niigata Prefectural Tokamachi Hospital, Japan. 10. Niigata Bandai Hospital, Japan. 11. Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan. 12. Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan. 13. Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Japan.
Abstract
OBJECTIVE: To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS: Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subjects (n = 284; male = 107, female = 177) had to return the questionnaires to their health care professional within 48 hours and undergo a diagnostic evaluation interview based on the Japanese version of M.I.N.I-Plus. RESULTS: 93 patients were diagnosed as having major depressive disorder (MDD). In the J-PHQ-9, the optimal cutpoint ≥ 10 had sensitivity of 90.5% and specificity of 76.6%. As for the categorical algorithms, the sensitivity was 80.6%; specificity was 89.5%, and a positive likelihood ratio of 7.7. The Stratum-specific likelihood ratios (SSLRs) of the J-PHQ-9 scores of 0-9, 10-14, 15-19, and 20-27 for major depression were 0.10 (95% CI: 0.05-0.20), 1.67 (95% CI: 1.02-2.76), 5.41 (95% CI: 2.87-10.22), and 11.98 (95% CI: 5.39-26.63), respectively. The relationship between the severity of J-PHQ-9 and the MCS of SF-8 was significant (χ 2 ＝ 85.72, df = 4, P ≤ 0.0001). CONCLUSIONS: This study has validated the J-PHQ-9 as a useful tool for the assessment of MDD in primary care in Japan.
OBJECTIVE: To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS:Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subjects (n = 284; male = 107, female = 177) had to return the questionnaires to their health care professional within 48 hours and undergo a diagnostic evaluation interview based on the Japanese version of M.I.N.I-Plus. RESULTS: 93 patients were diagnosed as having major depressive disorder (MDD). In the J-PHQ-9, the optimal cutpoint ≥ 10 had sensitivity of 90.5% and specificity of 76.6%. As for the categorical algorithms, the sensitivity was 80.6%; specificity was 89.5%, and a positive likelihood ratio of 7.7. The Stratum-specific likelihood ratios (SSLRs) of the J-PHQ-9 scores of 0-9, 10-14, 15-19, and 20-27 for major depression were 0.10 (95% CI: 0.05-0.20), 1.67 (95% CI: 1.02-2.76), 5.41 (95% CI: 2.87-10.22), and 11.98 (95% CI: 5.39-26.63), respectively. The relationship between the severity of J-PHQ-9 and the MCS of SF-8 was significant (χ 2 ＝ 85.72, df = 4, P ≤ 0.0001). CONCLUSIONS: This study has validated the J-PHQ-9 as a useful tool for the assessment of MDD in primary care in Japan.