A new PHQ-2 for Chinese adolescents: identifying core items of the PHQ-9 by network analysis

Child and Adolescent Psychiatry and Mental Health

Research

Yizhen Ren¹  Sitong Chen²  Zhanbing Ren²  Xinli Chi³  Kaixin Liang³  Yue Zhao³ 

[1] Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, 100875, Beijing, China;School of Physical Education and Sport, Shenzhen University, 518061, Shenzhen, China;School of Psychology, Shenzhen University, 518061, Shenzhen, China;The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, 518061, Shenzhen, China;

关键词: PHQ-9;    PHQ-2;    Depression;    Screening;    Adolescents;    Reliability;    Validity;    Scale;   

DOI  :  10.1186/s13034-023-00559-1

 received in 2022-08-21, accepted in 2023-01-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe importance of preventing and treating adolescent depression has been gradually recognized in Chinese society, especially in the context of the COVID-19 pandemic. Early screening is the first step. The Patient Health Questionnaire-9 (PHQ-9) is a leading scale in the field of depression screening. To improve screening efficiency in large-scale screening, an even shorten scale is desirable. The PHQ-2, which only included two items measuring anhedonia and depressed mood, is an ultra-form of the PHQ-9. However, emerging evidence suggests that there may be a better short form for the PHQ-9, especially for adolescents. Therefore, using two large samples of Chinese adolescents, this study aimed to identify the core items of the PHQ-9 and examine the short form consisting of core items.MethodsSurveys were conducted among primary and middle school students in two Chinese cities with different economic levels during the COVID-19 pandemic. Two gender-balanced samples aged 10 to 17 (nSample 1 = 67281, nSample 2 = 16726) were collected. Network analysis was used to identify the core items of the PHQ-9, which were extracted to combine a short version. Reliability, concurrent validity, and the receiver operating characteristic curve (ROC) of the short form were examined. Analyses were gender-stratified.ResultsNetwork analysis identified fatigue and depressed mood as core items in the PHQ-9 among Chinese adolescents. Items measuring Fatigue and Mood were combined to be a new PHQ-2 (PHQ-2 N). The PHQ-2 N displayed satisfactory internal consistency and current validity. Taking the PHQ-9 as a reference, the PHQ-2 N showed higher ROC areas and better sensitivity and specificity than the PHQ-2. The optimal cutoff score for the PHQ-2 N was 2 or 3.ConclusionsFatigue and depressed mood are the central symptoms of the depressive symptom network. The PHQ-2 N has satisfactory psychometric properties and can be used in rapid depression screening among Chinese adolescents.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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