Validation of the Patient Health Questionnaire-9 for Major Depressive Disorder in the Occupational Health Setting

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Web End = J Occup Rehabil (2016) 26:237244 DOI 10.1007/s10926-015-9607-0

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Web End = Validation of the Patient Health Questionnaire-9 for Major Depressive Disorder in the Occupational Health Setting

D. Volker1,2 M. C. Zijlstra-Vlasveld1 E. P. M. Brouwers2 W. A. Homans5

W. H. M. Emons3 C. M. van der Feltz-Cornelis2,4

Published online: 16 September 2015 The Author(s) 2015. This article is published with open access at Springerlink.com

Abstract Purpose Because of the increased risk of long-term sickness leave for employees with a major depressive disorder (MDD), it is important for occupational health professionals to recognize depression in a timely manner. The Patient Health Questionnaire-9 (PHQ-9) has proven to be a reliable and valid instrument for screening MDD, but has not been validated in the occupational health setting. The aim of this study was to validate the PHQ-9 for MDD within a population of employees on sickness leave by using the MINI-International Neuropsychiatric Interview (MINI) as a gold standard. Methods Participants were recruited in collaboration with the occupational health service. The study sample consisted of 170 employees on sickness leave between 4 and 26 weeks who completed the PHQ-9 and were evaluated with the MINI by telephone. Sensitivity, specicity, positive and negative predictive value, efciency and 95 % condence intervals (95 % CIs) were calculated for all possible cut-off values. A receiver operator characteristics (ROC) analysis was computed for PHQ-9 score versus the MINI. Results The optimal cut-off value of the PHQ-9 was 10. This resulted in a sensitivity of86.1 % [95 % CI (69.794.8)] and a specicity of 78.4 % [95 % CI (70.284.8)]. Based on the ROC analysis, the

area under the curve for the PHQ-9 was 0.90 [SE = 0.02; 95 % CI (0.850.94)]. Conclusion The PHQ-9 shows good sensitivity and specicity as a screener for MDD within a population of employees on sickness leave.

Keywords PHQ-9 Major depressive disorder

Validation study Occupational health setting

Introduction

Major depressive disorders (MDD) are highly associated with sickness leave, and lead to personal suffering and high societal costs [1, 2]. The yearly prevalence...