Ajele Kenni Wojujutari, Idemudia Erhabor Sunday
Faculty of Humanities, North-West University, Mafikeng, South Africa.
Discov Ment Health. 2025 Apr 7;5(1):50. doi: 10.1007/s44192-025-00181-x.
Depression is a leading cause of disability worldwide, requiring reliable and adaptable screening tools. The Patient Health Questionnaire- 9 (PHQ- 9) is widely used, yet its reliability across diverse populations and cultural adaptations remains unclear.
This meta-analysis assessed the reliability generalization of the PHQ- 9 across different populations, settings, and cultural contexts to determine its applicability in global mental health assessments.
A reliability generalization (RG) meta-analysis was conducted on 60 studies with 232,147 participants. A random-effects model was used to estimate pooled internal consistency (Cronbach's α) and test-retest reliability. Subgroup analyses examined the effects of administration modes, cultural adaptations, and study settings.
The pooled Cronbach's α was 0.86 (95% CI [0.85, 0.87]), indicating high internal consistency. Test-retest reliability, based on eight studies, was 0.82 (95% CI [0.74, 0.90]). Self-administered formats had the highest reliability (α = 0.87), while face-to-face interviews were lower (α = 0.80). Substantial heterogeneity (I = 99.3%) was observed.
The PHQ- 9 is a reliable depression screening tool globally, but significant heterogeneity highlights the need for continued cultural adaptation and validation to enhance its applicability across diverse contexts.
抑郁症是全球致残的主要原因，需要可靠且适用的筛查工具。患者健康问卷-9（PHQ-9）被广泛使用，但其在不同人群中的可靠性以及文化适应性仍不明确。
本荟萃分析评估了PHQ-9在不同人群、环境和文化背景下的可靠性泛化情况，以确定其在全球心理健康评估中的适用性。
对60项研究中的232147名参与者进行了可靠性泛化（RG）荟萃分析。采用随机效应模型估计合并的内部一致性（克朗巴哈α系数）和重测信度。亚组分析考察了施测方式、文化适应性和研究环境的影响。
合并的克朗巴哈α系数为0.86（95%置信区间[0.85, 0.87]），表明内部一致性较高。基于八项研究的重测信度为0.82（95%置信区间[0.74, 0.90]）。自填式格式的可靠性最高（α = 0.87），而面对面访谈的可靠性较低（α = 0.80）。观察到显著的异质性（I² = 99.3%）。
PHQ-9是一种全球范围内可靠的抑郁症筛查工具，但显著的异质性凸显了持续进行文化适应和验证以提高其在不同背景下适用性的必要性。
