Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda

Autor: Josiane Umwiringirwa, Dirk E. Teuwen, Peter Dedeken, Paul E. Boon, Fidèle Sebera, João Ricardo Nickenig Vissoci
Jazyk: angličtina
Rok vydání: 2020
Předmět:
DISORDER
Male
SYMPTOMS
Psychometrics
Social Sciences
Validity
Patient Health Questionnaire
Severity of Illness Index
Geographical Locations
Mathematical and Statistical Techniques
0302 clinical medicine
Medicine and Health Sciences
ANXIETY
Psychology
RATING-SCALE
Depression (differential diagnoses)
Reliability (statistics)
Multidisciplinary
Depression
Statistics
PRIMARY-CARE
PHQ-9
Confirmatory factor analysis
Neurology
Area Under Curve
Physical Sciences
Medicine
Female
Factor Analysis
Research Article
Adult
medicine.medical_specialty
Adolescent
Science
Research and Analysis Methods
behavioral disciplines and activities
VALIDATION
External validity
Young Adult
03 medical and health sciences
PEOPLE
Diagnostic Medicine
Rating scale
Mental Health and Psychiatry
medicine
Humans
Statistical Methods
Epilepsy
Mood Disorders
business.industry
Rwanda
Reproducibility of Results
Biology and Life Sciences
ADULTS
Translating
030227 psychiatry
ROC Curve
People and Places
Africa
Physical therapy
TRANSLATION
business
Mathematics
030217 neurology & neurosurgery
Zdroj: PLoS ONE, Vol 15, Iss 6, p e0234095 (2020)
PLoS ONE
PLOS ONE
ISSN: 1932-6203
Popis: BackgroundPatients with epilepsy (PwE) have an increased risk of active and lifetime depression. Two in 10 patients experience depression. Lack of trained psychiatric staff in low- and middle-income countries (LMIC) creates a need for screening tools that enable detection of depression in PwE. We describe the translation, validity and reliability assessment of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for depression among PwE in Rwanda.MethodPHQ-9 was translated to Kinyarwanda using translation-back translation and validated by a discussion group. For validation, PwE of ≥15 years of age were administered the PHQ-9 and Hamilton Depression Rating Scale (HDRS) by trained psychiatry staff at Visit 1. A random sample of 20% repeated PHQ-9 and HDRS after 14 days to assess temporal stability and intra-rater reliability. Internal structure, reliability and external validity were assessed using confirmatory factor analysis, reliability coefficients and HDRS-correlation, respectively. Maximal Youden's index was considered for cut-offs.ResultsFour hundred and thirty-four PwE, mean age 30.5 years (SD ±13.3), were included of whom 33.6%, 37.9%, 13.4%, and 15.1% had no, mild, moderate and severe depression, respectively. PHQ-9 performed well on a one-factor model (unidimensional model), with factor loadings of 0.63-0.86. Reliability coefficients above 0.80 indicated strong internal consistency. Good temporal stability was observed (0.79 [95% CI: 0.68-0.87]). A strong correlation (R = 0.66, p = 0.01) between PHQ-9 and HDRS summed scores demonstrated robust external validity. The optimal cut-off for the PHQ-9 was similar (≥5) for mild and moderate depression and ≥7 for severe depression.ConclusionPHQ-9 validation in Kinyarwanda creates the capacity to screen PwE in Rwanda at scores of ≥5 for mild or moderate and ≥7 for severe depression. The availability of validated tools for screening and diagnosis for depression is a forward step for holistic care in a resource-limited environment.
Databáze: OpenAIRE
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