A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population

Bernd Löwe; Inka Wahl; Matthias Rose; Carsten Spitzer; Heide Glaesmer; Katja Wingenfeld; Antonius Schneider; Elmar Brähler

doi:10.1016/j.jad.2009.06.019

A 4-item measure of depression and anxiety

Standard

A 4-item measure of depression and anxiety : validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. / Löwe, Bernd; Wahl, Inka; Rose, Matthias; Spitzer, Carsten; Glaesmer, Heide; Wingenfeld, Katja; Schneider, Antonius; Brähler, Elmar.

in: J AFFECT DISORDERS, Jahrgang 122, Nr. 1-2, 01.04.2010, S. 86-95.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Löwe, B, Wahl, I, Rose, M, Spitzer, C, Glaesmer, H, Wingenfeld, K, Schneider, A & Brähler, E 2010, 'A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population', J AFFECT DISORDERS, Jg. 122, Nr. 1-2, S. 86-95. https://doi.org/10.1016/j.jad.2009.06.019

APA

Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., Schneider, A., & Brähler, E. (2010). A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J AFFECT DISORDERS, 122(1-2), 86-95. https://doi.org/10.1016/j.jad.2009.06.019

Vancouver

Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J AFFECT DISORDERS. 2010 Apr 1;122(1-2):86-95. https://doi.org/10.1016/j.jad.2009.06.019

Bibtex

@article{ac9f9de2a8c64391a93acd38573b2a13,

title = "A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population",

abstract = "BACKGROUND: The 4-item Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report questionnaire that consists of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). Given that PHQ-4, PHQ-2, and GAD-2 have not been validated in the general population, this study aimed to investigate their reliability and validity in a large general population sample and to generate normative data.METHODS: A nationally representative face-to-face household survey was conducted in Germany in 2006. The survey questionnaire consisted of the PHQ-4, other self-report instruments, and demographic characteristics.RESULTS: Of the 5030 participants (response rate=72.9%), 53.6% were female and mean (SD) age was 48.4 (18.0) years. The sociodemographic characteristics of the study sample closely match those of the total populations in Germany as well as those in the United States. Confirmatory factor analyses showed very good fit indices for a two-factor solution (RMSEA .027; 90% CI .023-.032). All models tested were structurally invariant between different age and gender groups. Construct validity of the PHQ-4, PHQ-2, and GAD-2 was supported by intercorrelations with other self-report scales and with demographic risk factors for depression and anxiety. PHQ-2 and GAD-2 scores of 3 corresponded to percentile ranks of 93.4% and 95.2%, respectively, whereas PHQ-2 and GAD-2 scores of 5 corresponded to percentile ranks of 99.0% and 99.2%, respectively.LIMITATION: A criterion standard diagnostic interview for depression and anxiety was not included.CONCLUSIONS: Results from this study support the reliability and validity of the PHQ-4, PHQ-2, and GAD-2 as ultra-brief measures of depression and anxiety in the general population. The normative data provided in this study can be used to compare a subject's scale score with those determined from a general population reference group.",

keywords = "Adult, Aged, Anxiety Disorders, Depressive Disorder, Female, Germany, Health Surveys, Humans, Male, Mass Screening, Middle Aged, Psychometrics, Questionnaires, Reproducibility of Results",

author = "Bernd L{\"o}we and Inka Wahl and Matthias Rose and Carsten Spitzer and Heide Glaesmer and Katja Wingenfeld and Antonius Schneider and Elmar Br{\"a}hler",

year = "2010",

month = apr,

day = "1",

doi = "10.1016/j.jad.2009.06.019",

language = "English",

volume = "122",

pages = "86--95",

journal = "J AFFECT DISORDERS",

issn = "0165-0327",

publisher = "Elsevier",

number = "1-2",

}

RIS

TY - JOUR

T1 - A 4-item measure of depression and anxiety

T2 - validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population

AU - Löwe, Bernd

AU - Wahl, Inka

AU - Rose, Matthias

AU - Spitzer, Carsten

AU - Glaesmer, Heide

AU - Wingenfeld, Katja

AU - Schneider, Antonius

AU - Brähler, Elmar

PY - 2010/4/1

Y1 - 2010/4/1

N2 - BACKGROUND: The 4-item Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report questionnaire that consists of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). Given that PHQ-4, PHQ-2, and GAD-2 have not been validated in the general population, this study aimed to investigate their reliability and validity in a large general population sample and to generate normative data.METHODS: A nationally representative face-to-face household survey was conducted in Germany in 2006. The survey questionnaire consisted of the PHQ-4, other self-report instruments, and demographic characteristics.RESULTS: Of the 5030 participants (response rate=72.9%), 53.6% were female and mean (SD) age was 48.4 (18.0) years. The sociodemographic characteristics of the study sample closely match those of the total populations in Germany as well as those in the United States. Confirmatory factor analyses showed very good fit indices for a two-factor solution (RMSEA .027; 90% CI .023-.032). All models tested were structurally invariant between different age and gender groups. Construct validity of the PHQ-4, PHQ-2, and GAD-2 was supported by intercorrelations with other self-report scales and with demographic risk factors for depression and anxiety. PHQ-2 and GAD-2 scores of 3 corresponded to percentile ranks of 93.4% and 95.2%, respectively, whereas PHQ-2 and GAD-2 scores of 5 corresponded to percentile ranks of 99.0% and 99.2%, respectively.LIMITATION: A criterion standard diagnostic interview for depression and anxiety was not included.CONCLUSIONS: Results from this study support the reliability and validity of the PHQ-4, PHQ-2, and GAD-2 as ultra-brief measures of depression and anxiety in the general population. The normative data provided in this study can be used to compare a subject's scale score with those determined from a general population reference group.

AB - BACKGROUND: The 4-item Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report questionnaire that consists of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). Given that PHQ-4, PHQ-2, and GAD-2 have not been validated in the general population, this study aimed to investigate their reliability and validity in a large general population sample and to generate normative data.METHODS: A nationally representative face-to-face household survey was conducted in Germany in 2006. The survey questionnaire consisted of the PHQ-4, other self-report instruments, and demographic characteristics.RESULTS: Of the 5030 participants (response rate=72.9%), 53.6% were female and mean (SD) age was 48.4 (18.0) years. The sociodemographic characteristics of the study sample closely match those of the total populations in Germany as well as those in the United States. Confirmatory factor analyses showed very good fit indices for a two-factor solution (RMSEA .027; 90% CI .023-.032). All models tested were structurally invariant between different age and gender groups. Construct validity of the PHQ-4, PHQ-2, and GAD-2 was supported by intercorrelations with other self-report scales and with demographic risk factors for depression and anxiety. PHQ-2 and GAD-2 scores of 3 corresponded to percentile ranks of 93.4% and 95.2%, respectively, whereas PHQ-2 and GAD-2 scores of 5 corresponded to percentile ranks of 99.0% and 99.2%, respectively.LIMITATION: A criterion standard diagnostic interview for depression and anxiety was not included.CONCLUSIONS: Results from this study support the reliability and validity of the PHQ-4, PHQ-2, and GAD-2 as ultra-brief measures of depression and anxiety in the general population. The normative data provided in this study can be used to compare a subject's scale score with those determined from a general population reference group.

KW - Adult

KW - Aged

KW - Anxiety Disorders

KW - Depressive Disorder

KW - Female

KW - Germany

KW - Health Surveys

KW - Humans

KW - Male

KW - Mass Screening

KW - Middle Aged

KW - Psychometrics

KW - Questionnaires

KW - Reproducibility of Results

U2 - 10.1016/j.jad.2009.06.019

DO - 10.1016/j.jad.2009.06.019

M3 - SCORING: Journal article

C2 - 19616305

VL - 122

SP - 86

EP - 95

JO - J AFFECT DISORDERS

JF - J AFFECT DISORDERS

SN - 0165-0327

IS - 1-2

ER -