The diagnostic accuracy of the 9-item patient health questionnaire as a depression screening instrument in Arabic-speaking cancer patients

Abstract

Objectives

To examine the accuracy of an Arabic version of the Patient Health Questionnaire 9 (PHQ-9) in predicting depression in cancer patients.

Methods

Cancer patients were recruited from a tertiary care hospital in Saudi Arabia. After completing the PHQ-9, they were interviewed for demographics, clinical background and the major depressive episode (MDE) assessment of the Mini International Neuropsychiatric Interview (MINI) scale.

Results

Out of the 407 recruited patients, 60 (14.7 %) patients were found to have current MDE based on the MINI. The psychometric assessment of PHQ-9 showed an acceptable internal consistency (Cronbach’s alpha = 0.798) and excellent performance for the area under the curve (0.91, 95 % confidence internal [CI], 0.88 – 0.95). Based on the Youden index, a score of ≥ 9 provided the optimum cutoff score with a sensitivity of 88 % (95 % CI, 77 %–95 %), a specificity of 80 % (95 % CI, 75 %–84 %), a positive predictive value of 43 %, and a negative predictive value of 98 %.

Limitations

The study was carried out at one center where the sample might not be representative to all cancer patients in Saudi Arabia. Also, detailed clinical information was not collected.

Conclusions

The PHQ-9 with a cutoff score of ≥ 9 performed well in identifying MDE in Arabic-speaking cancer patients and could be considered as a suitable instrument for this population.