Validity of the patient health questionnaires (phq-2 and phq-9) for screening depression among human immunodeficiency virus patients in Lahore, Pakistan

doi:10.5501/wjv.v11.i5.341

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World Journal of Virology

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Observational Study

World J Virol. Sep 25, 2022; 11(5): 341-351
Published online Sep 25, 2022. doi: 10.5501/wjv.v11.i5.341

Validity of the patient health questionnaires (phq-2 and phq-9) for screening depression among human immunodeficiency virus patients in Lahore, Pakistan

Khunsa Junaid, Iqra Akram, Muhammad Daood, Amjad Khan

Khunsa Junaid, Muhammad Daood, Department of Community Medicine, King Edward Medical University, Lahore 54000, Punjab Province, Pakistan

Iqra Akram, Department of Pulmonology, General Hospital, Lahore 54000, Punjab Province, Pakistan

Amjad Khan, Department of Public Health and Nutrition, the University of Haripur, Haripur 22781, Khyber Pakhtunkhwa, Pakistan

Author contributions: All authors contributed to the concept of this study; Junaid K, Akram I conceived the study; Daood M carried out the literature searches; Junaid K distributed the questionnaires and extracted the data; Daood M assessed the study quality; Junaid K and Khan A performed the statistical analysis; Junaid K and Daood M wrote the manuscript; Khan A revised the manuscript; all the authors read the published version of the manuscript and gave their consent.

Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Jinnah hospital Lahore, Pakistan.

Informed consent statement: Informed consent was obtained from all patients for being included in the study.

Conflict-of-interest statement: All the authors have no conflicts of interest.

Data sharing statement: Participants gave informed consent for data sharing and the presented data are anonymized and the risk of identification is low.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Corresponding author: Khunsa Junaid, Post-graduate trainee, Department of Community Medicine, King Edward Medical University, Lahore 54000, Punjab Province, Pakistan. khunsajunaidmir@gmail.com

Received: March 20, 2022
Peer-review started: March 20, 2022
First decision: April 18, 2022
Revised: May 6, 2022
Accepted: August 26, 2022
Article in press: August 26, 2022
Published online: September 25, 2022
Processing time: 187 Days and 21.2 Hours

Abstract

BACKGROUND

Many human immunodeficiency virus (HIV) infected patients suffer from depr-ession, but a little focus is given to detecting and treating depression in primary health care. Detection of depression can be improved by introducing short, reliable, and valid screening instruments.

AIM

To determine the psychometric properties of the patient health questionnaire-2 (PHQ-2) and patient health questionnaire-9 (PHQ-9) for depression screening and diagnosis, and the sensitivity and specificity of the PHQ-2 in HIV infected patients.

METHODS

A cross-sectional study was conducted on 158 HIV-infected patients aged 18 years and above in Lahore, Pakistan. PHQ-2 was implemented to screen depression. PHQ-9 was implemented to diagnose major depressive disorder as a reference standard. Reliability, Validity tests and receiver operating characteristic curve were computed.

RESULTS

The Cronbach's alpha of PHQ-2 and PHQ-9 were 0.732 and 0.759, respectively. The study results showed that the score of 2 on PHQ-2 indicates the highest Youden's index of 0.924, with both sensitivity and specificity of 0.96, and the area under the curve for PHQ-2 was 0.98 (95%CI: 0.953-0.998).

CONCLUSION

Good psychometric properties for the PHQ-2 and PHQ-9 indicated their significant potential as tools for depression screening and diagnosis in the HIV-infected population.

Keywords: Depression; Validity; Patient health questionnaire-9; Patient health questionnaire-2; HIV/AIDS; Lahore; Pakistan

Core Tip: Many human immunodeficiency virus patients suffer from depression, but a little focus is given to detecting and treating depression in primary healthcare settings. The study aims to assess the psychometric properties of the patient health questionnaire-2 (PHQ-2) and Patient health questionnaire-9 for depression screening and diagnosis and estimate the sensitivity and specificity of the PHQ-2 for depression screening in human immunodeficiency virus infected patients. The study results showed that the score of 2 on PHQ-2 indicates the highest Youden's index of 0.924, with both sensitivity and specificity of 0.96, and the area under the curve for PHQ-2 was 0.98.