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Background: The Patient Health Questionnaire
depression module (PHQ-9) is a brief (10 items) screening and
monitoring measure designed for use in primary care settings that
operationalizes most of the DSM-IV and ICD-9 diagnostic criteria
for major depression. In the United States, the PHQ-9 has become
the recommended depression measure in primary care settings.
However, there are no published reports of its use in developing
countries and no reports of the feasibility of using the Spanish
version of the PHQ-9 to screen for depression.
Method: During a medical brigade in October
2001, we tested the feasibility of using the Spanish PHQ-9 to
screen for major depression in primary care clinics. A team of
U.S. and Honduran physicians and medical students assessed 199
mothers of children under 10 years of age as part of a depression
prevalence study in 5 rural sites.
Results: The PHQ-9 proved easy to administer to
this population of poor, rural, young, and mostly illiterate
Honduran women who had never participated in research before.
Rater training required about 30 minutes of instruction for this
group of physicians and medical students, plus occasional
questions on the first day of use. Duration of administration of
the PHQ-9 by interview ranged from 3 to 15 minutes. No items
required major modification for cultural differences. The PHQ-9
identified a rate of 15% for major depression in this sample, and
the PHQ-9 results showed a sensitivity of 77% and a specificity
of 100% compared with the Structured Clinical Interview for
DSM-IV mood disorders module.
Conclusion: Like the English PHQ-9, the Spanish
PHQ-9 is an efficient and reliable screening measure for major
depression in primary care. It is useful as a research measure
for estimating the prevalence of major depression and as an aid
to the primary care clinician in rural Honduras.
Prim Care Companion J Clin Psychiatry 2002;4(5):191-195
https://doi.org/10.4088/PCC.v04n0504
© Copyright 2002 Physicians Postgraduate Press, Inc.