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J Affect Disord. 2013 May 15;148(1):77-83. doi: 10.1016/j.jad.2012.11.052. Epub 2012 Dec 14.

A comparison of the PRIME-MD PHQ-9 and PHQ-8 in a large military prospective study, the Millennium Cohort Study.

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1
Deployment Health Research Department, Naval Health Research Center, San Diego, CA, USA.

Abstract

BACKGROUND:

In light of increased concerns about suicide in the military, institutional review boards have mandated increased scrutiny of the final item on the depression screening tool, the PHQ-9, which asks about suicidal thoughts. Since real-time monitoring of all individual responses in most observational studies is not feasible, many investigators have adopted the PHQ-8, choosing to remove the ninth item. This study compares the performance of the PHQ-8 with the PHQ-9 in a population-based sample of military or nonmilitary subjects.

METHODS:

The Millennium Cohort Study administers a self-reported questionnaire that includes the PHQ-9 at 3-year intervals to current and former U.S. military personnel. PHQ-9 responses of 143,705 Millennium Cohort members were investigated. Cross-sectional comparisons of the PHQ-9 and PHQ-8 and prospective analyses to detect a 5-unit change in these measures were performed.

RESULTS:

Greater than substantial agreement was found between the PHQ-8 and 9 instruments (kappas, 0.966-0.974 depending on survey cycle). There was similarly high agreement between the PHQ-8 and 9 in detecting a 5-point increase (κ=0.987) or decrease (κ=0.984) in score.

LIMITATIONS:

One potential limitation of this study is that participants completed the PHQ-9, and PHQ-8 scores were extrapolated from the PHQ-9. In addition, the Millennium Cohort may not fully represent the U.S. military; though previous evaluations have shown the cohort to be a well-representative sample.

CONCLUSIONS:

Since excellent agreement was detected between the PHQ-8 and PHQ-9 instruments, the PHQ-8 would capture nearly all the same cases of depression as the PHQ-9 in populations similar to the one in this study.

PMID:
23246365
DOI:
10.1016/j.jad.2012.11.052
[Indexed for MEDLINE]

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