Validation of the Patient Health Questionnaire–9 and Patient Health Questionnaire–2 in the General Korean Population

Kim, Minah; Jung, Sanghyup; Park, Jee Eun; Sohn, Jee Hoon; Seong, Su Jeong; Kim, Byung-Soo; Chang, Sung Man; Hong, Jin Pyo; Hahm, Bong-Jin; Yeom, Chan-Woo

doi:2023.20.9.853

Psychiatry Investig > Volume 20(9); 2023 > Article

Original Article

Psychiatry Investigation 2023;20(9):853-860.
DOI: https://doi.org/10.30773/pi.2023.0100 Published online September 19, 2023.

Validation of the Patient Health Questionnaire–9 and Patient Health Questionnaire–2 in the General Korean Population

Minah Kim^1,2

, Sanghyup Jung³

, Jee Eun Park^1,2

, Jee Hoon Sohn^1,4

, Su Jeong Seong⁵

, Byung-Soo Kim⁶

, Sung Man Chang⁶

, Jin Pyo Hong⁷

, Bong-Jin Hahm^1,3,8

, Chan-Woo Yeom⁹

^¹Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
^²Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
^³Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
^⁴Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea
^⁵Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
^⁶Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
^⁷Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
^⁸Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
^⁹Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeonbu, Republic of Korea

Correspondence: Chan-Woo Yeom ,Tel: +82-31-951-2379, Fax: +82-31-951-1093, Email: chwoye@gmail.com, chwoye@eulji.ac.kr

Received: April 1, 2023 Revised: May 26, 2023 Accepted: June 30, 2023 Published online: September 19, 2023

Abstract

Objective
The Patient Health Questionnaire–9 (PHQ-9) and PHQ-2 have not been validated in the general Korean population. This study aimed to validate and identify the optimal cutoff scores of the PHQ-9 and PHQ-2 in screening for major depression in the general Korean population.
Methods
We used data from 6,022 participants of the Korean Epidemiological Catchment Area Study for Psychiatric Disorders in 2011. Major depression was diagnosed according to the Korean Composite International Diagnostic Interview. Validity, reliability, and receiver operating characteristic curve analyses were performed using the results of the PHQ-9 and Euro Quality of life-5 dimension (EQ-5d).
Results
Of the 6,022 participants, 150 were diagnosed with major depression (2.5%). Both PHQ-9 and PHQ-2 demonstrated relatively high reliability and their scores were highly correlated with the “anxiety/depression” score of the EQ-5d. The optimal cutoff score of the PHQ-9 was 5, with a sensitivity of 89.9%, specificity of 84.1%, positive predictive value (PPV) of 12.6%, negative predictive value (NPV) of 99.7%, positive likelihood ratio (LR+) of 5.6, and negative likelihood ratio (LR-) of 0.12. The optimal cutoff score of the PHQ-2 was 2, with a sensitivity of 85.3%, specificity of 83.2%, PPV of 11.6%, NPV of 99.5%, LR+ of 5.1, and LR- of 0.18.
Conclusion
The PHQ-9 and PHQ-2 are valid tools for screening major depression in the general Korean population, with suggested cutoff values of 5 and 2 points, respectively.

Key words Depression; PHQ-9; PHQ-2; Screening; Cutoff; Korea