The Patient Health Questionnaire-9 as a Screening Tool for Depression in Individuals with Type 2 Diabetes Mellitus: The Maastricht Study

Autor: Sebastian Köhler, Frans R.J. Verhey, Simone J. S. Sep, Pieter C. Dagnelie, Nicolaas C. Schaper, Eveline P. C. J. Janssen, Ronald M.A. Henry, Miranda T. Schram, Carla J.H. van der Kallen, Coen D.A. Stehouwer
Přispěvatelé: Promovendi MHN, Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: HVC Pieken Maastricht Studie (9), Interne Geneeskunde, MUMC+: MA Interne Geneeskunde (3), RS: CARIM - R3.01 - Vascular complications of diabetes and the metabolic syndrome, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: MA Endocrinologie (9), RS: CARIM - R3.02 - Hypertension and target organ damage, RS: CAPHRI - R5 - Optimising Patient Care, Epidemiologie, MUMC+: MA Med Staf Spec Psychiatrie (9)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
diabetes mellitus type 2
endocrine system diseases
Psychometrics
Population
Patient Health Questionnaire-9
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Cronbach's alpha
depressive disorder
Internal medicine
Surveys and Questionnaires
Interview
Psychological
medicine
Humans
Mass Screening
030212 general & internal medicine
education
Psychiatry
Mini-international neuropsychiatric interview
Aged
Netherlands
education.field_of_study
Receiver operating characteristic
business.industry
Depression
screening
nutritional and metabolic diseases
Middle Aged
humanities
Confirmatory factor analysis
Patient Health Questionnaire
Diabetes Mellitus
Type 2
ROC Curve
Female
Mini-International Neuropsychiatric Interview
Geriatrics and Gerontology
business
Factor Analysis
Statistical
030217 neurology & neurosurgery
Kappa
Cohort study
Zdroj: Journal of the American Geriatrics Society, 64(11), E201-E206. Wiley
ISSN: 0002-8614
DOI: 10.1111/jgs.14388
Popis: Objectives To assess the psychometric properties and identify the best cutoff value of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in individuals with type 2 diabetes mellitus (T2DM). Design Observational population-based cohort study. Setting The Maastricht Study. Participants Individuals with and without T2DM (mean age 58.6 ± 8.1, 44.6% male) according to an oral glucose tolerance test (N = 2,997). Measurements Depressive disorder and depressive symptoms were measured using the Mini-International Neuropsychiatric Interview (MINI) as the reference and the PHQ-9. Cronbach alpha, Cohen's kappa and receiver operating characteristic (ROC) analyses were used. Differences in factorial structure between participants with and without T2DM were tested using multigroup confirmatory factor analysis. Results Based on the traditional PHQ-9 cutoff value, 133 (4.4%) participants had depressive symptoms (PHQ-9 score ≥10). Internal consistency of the PHQ-9 was good (Cronbach α = 0.87 with T2DM, 0.82 without T2DM), the kappa of agreement between the PHQ-9 and the MINI was moderate (0.40 with T2DM, 0.43 without T2DM). Area under the ROC curve for the PHQ-9 was 0.87 in participants with T2DM and 0.88 in those without. A PHQ-9 cutoff score of 5 provided the best sensitivity (92.3%), with acceptable specificity (70.4%), for T2DM, similar to sensitivity and specificity in individuals without T2DM. Factor analysis suggested a similar two-factor structure in both groups (affective and somatic symptoms). Conclusion Patient Health Questionnaire-9 performs well as a screening tool for depressive symptoms in individuals with and without T2DM based on the cutoff value of 5, indicating that the PHQ-9 can be used in two-stage screening in primary care to select individuals with T2DM for further psychological evaluation.
Databáze: OpenAIRE
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