Assessment of depression severity with the PHQ-9 in cancer patients and in the general population

BMC Psychiatry

Research Article

Susanne Singer¹  Andreas Hinz²  Elmar Brähler³  Rüya-Daniela Kocalevent⁴  Thomas Forkmann⁵  Thomas Schulte⁶  Anja Mehnert⁷ 

[1] Department of Medical Biostatistics, Epidemiology, and Informatics, University of Mainz, Mainz, Germany;Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany;Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany;Department of Psychosomatic Medicine and Psychotherapy, University of Mainz, Mainz, Germany;Institute and Policlinic for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Aachen, Germany;Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany;Section of Psychooncology, Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany;

关键词: Depression;    Cancer;    Depressive symptoms;    Psychometrics;   

DOI  :  10.1186/s12888-016-0728-6

 received in 2014-12-16, accepted in 2016-01-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe Patient Health Questionnaire PHQ-9 is a widely used instrument to screen for depression in clinical research. The first aim of this study was to psychometrically test the PHQ-9 in a large sample of cancer patients. The second aim was to calculate unbiased estimates of the depression burden for several cancer groups taking into account age and gender distributions.MethodsA sample of 2,059 cancer patients with varying diagnoses were examined in this study six months after discharge from a rehabilitation clinic. A representative sample of 2,693 people from the general population served as controls. Expected PHQ-9 mean scores of the general population sample, regressed on age and gender, were calculated to enable a fair comparison of different groups of cancer patients.ResultsWhile the reliability (Cronbach’s alpha) for the PHQ-9 scale was good (alpha ≥ 0.84), the CFA fit indices of the one-dimensional solution were unsatisfactory in the patients’ sample. The factorial analysis confirmed two factors. PHQ-9 mean scores for 15 types of cancer are given, ranging from 4.0 (prostate) to 8.2 (thyroid gland). Differences between expected mean scores (derived from the general population) and raw mean scores of the cancer subsamples are reported that provide a better estimate of the depression burden.ConclusionsThe results confirmed that the PHQ-9 performs well in testing depression in cancer patients. Regression coefficients can be used for performing unbiased comparisons among cancer groups, not only for this study. The burden of patients with testis cancer and Hodgkin lymphoma is underestimated when age and gender are not taken into account.

【 授权许可】

CC BY   
© Hinz et al. 2016