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

Table 1 Socio demographic characteristics of human immunodeficiency virus positive patients (n = 158)

Variables	Non-depression, n (%)	Depression, n (%)	P value
	104 (65.8)	54 (34.1)
Age (yr)
mean ± SD	30.42 ± 7.11	43.91 ± 5.133	0.001a
Gender
Male	89 (56.3)	46 (29.1)	0.947
Female	15 (9.5)	8 (5.1)
Education
No education	62 (39.2)	27 (17.1)	0.377
Up to primary school	11 (7.0)	6 (3.8)
Up to secondary school	23 (14.6)	14 (8.9)
Up to college	4 (2.5)	6 (3.8)
Up to University	4 (2.5)	1 (0.6)
Marital status
Married	51 (32.3)	42 (26.6)	0.001a
Unmarried	47 (29.7)	4 (2.5)
Separated	1 (0.6)	5 (3.2)
Divorced	4 (2.5)	2 (1.3)
Widowed	1 (0.6)	0 (0.6)
Monthly family income
Less than 20000 Rs	66 (41.8)	17 (10.8)	0.001a
Between Rs. 20000-30000	29 (18.4)	25 (15.8)
More than Rs. 30000	9 (5.7)	12 (7.6)
Residential status
Rural	36 (22.8)	25 (15.8)	0.153
Urban	68 (43.0)	29 (18.4)
Religion
Muslim	101 (63.9)	50 (31.6)	0.190
Non-Muslim	3 (1.9)	4 (2.5)

^aP value < 0.05.

Table 2 Item analysis of patient health questionnaire-9

PHQ-9	Mean	SD	Item-total correlation	α if item deleted
Little interest or pleasure in doing things	1.06	1.005	0.432	0.738
Feeling down, depressed, or hopeless	1.01	1.003	0.301	0.761
Trouble falling or staying asleep, or sleeping too much	1.06	0.975	0.422	0.739
Feeling tired or having little energy	1.27	0.803	0.414	0.740
Poor appetite or overeating	1.15	0.797	0.460	0.733
Feeling bad about yourself — or that you are a failure or have let yourself or your family down	1.07	0.775	0.518	0.726
Trouble concentrating on things, such as reading a newspaper or watching television	1.13	0.799	0.381	0.745
Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual	1.11	0.834	0.496	0.728
Thoughts that you would be better off dead or of hurting yourself in some way	1.06	0.926	0.559	0.716

PHQ-9: Patient health questionnaire-9.

Table 3 Sensitivity, specificity, predictive values, at various cut-off scores of the patient health questionnaire-2

PHQ-2 score	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	Youden’s index
≥ 1	100.00 (93.4-100.0)	59.62 (49.5-69.1)	21.6 (17.9-25.8)	100.0 (93.4-100.)	59.62
≥ 2	96.30 (87.3-99.5)	96.15 (90.4-98.9)	73.6 (51.5-87.9)	99.6 (98.4-99.9)	92.45
≥ 3	66.67 (52.5-78.9)	100.(96.5-100.0)	100.0 (96.5-100.0)	96.4(94.9-97.5)	66.67
≥ 4	31.48 (96.5-100.0)	100.0 (96.5-100.0)	100.0 (96.5-100.0)	92.9 (91.6-94.0)	31.48
≥ 5	14.81 (6.6-27.1)	100.0 (96.5-100.0)	100.0 (96.5-100.0)	91.4 (90.4-92.2)	14.81

PHQ-2: Patient health questionnaire-2; PPV: Positive predictive value; NPV: Negative predictive value.