Validation of the Patient Health Questionnaire-9 for depression screening among Chinese Americans.

OBJECTIVE

The objective of this study was to validate the Chinese Bilingual version of the Patient Health Questionnaire (CB-PHQ-9) for screening for depression among Chinese Americans in primary care.

METHOD

Chinese-American patients attending a primary care clinic were screened for major depressive disorder (MDD) using the CB-PHQ-9. All patients who scored 15 or higher on the CB-PHQ-9 were interviewed using the Chinese-bilingual Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, patient version. Eight percent of patients who scored less than 15 on the CB-PHQ-9 were randomly selected and interviewed with the depression module of the Chinese-bilingual Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, patient version.

RESULTS

During the study, 1940 unduplicated patients completed the CB-PHQ-9. The CB-PHQ-9 had high internal consistency (alpha = 0.91), and the scores of each of its 9 items had moderate to moderately high correlations (0.52-0.85) with the total scores. The sensitivity and specificity of the CB-PHQ-9 for recognizing MDD were found to be 81% and 98%, respectively, and the area under the receiver operating characteristic curve was estimated to be 0.97 (SE, 0.01).

CONCLUSION

The CB-PHQ-9 is a valid and useful instrument for screening for MDD among Chinese Americans in primary care.