Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9)
Background The Patient Health Questionnaire-9 (PHQ-9) is a widely used measure of depression in primary care. It was, however, originally designed as a diagnostic screening tool, and not for measuring change in response to antidepressant treatment. Although the Quick Inventory of Depressive Symptom...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-07-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472421009534/type/journal_article |
| _version_ | 1811156913789861888 |
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| author | Phillippa Harrison Syndi Walton Diede Fennema Suqian Duan Tanja Jaeckle Kimberley Goldsmith Ewan Carr Mark Ashworth Allan. H. Young Roland Zahn |
| author_facet | Phillippa Harrison Syndi Walton Diede Fennema Suqian Duan Tanja Jaeckle Kimberley Goldsmith Ewan Carr Mark Ashworth Allan. H. Young Roland Zahn |
| author_sort | Phillippa Harrison |
| collection | DOAJ |
| description |
Background
The Patient Health Questionnaire-9 (PHQ-9) is a widely used measure of depression in primary care. It was, however, originally designed as a diagnostic screening tool, and not for measuring change in response to antidepressant treatment. Although the Quick Inventory of Depressive Symptomology (QIDS-SR-16) has been extensively validated for outcome measurement, it is poorly adopted in UK primary care, and, although free for clinicians, has licensing restrictions for healthcare organisation use.
Aims
We aimed to develop a modified version of the PHQ-9, the Maudsley Modified PHQ-9 (MM-PHQ-9), for tracking symptom changes in primary care. We tested the measure's validity, reliability and factor structure.
Method
A sample of 121 participants was recruited across three studies, and comprised 78 participants with major depressive disorder and 43 controls. MM-PHQ-9 scores were compared with the QIDS-SR-16 and Clinical Global Impressions improvement scale, for concurrent validity. Internal consistency of the scale was assessed, and principal component analysis was conducted to determine the items’ factor structure.
Results
The MM-PHQ-9 demonstrated good concurrent validity with the QIDS-SR-16, and excellent internal consistency. Sensitivity to change over a 14-week period was d = 0.41 compared with d = 0.61 on the QIDS-SR-16. Concurrent validity between the paper and mobile app versions of the MM-PHQ-9 was r = 0.67.
Conclusions
These results indicate that the MM-PHQ-9 is a valid and reliable measure of depressive symptoms in paper and mobile app format, although further validation is required. The measure was sensitive to change, demonstrating suitability for use in routine outcome assessment.
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| first_indexed | 2024-04-10T04:59:06Z |
| format | Article |
| id | doaj.art-5fcfd016426b4a219518881a6c43480e |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:06Z |
| publishDate | 2021-07-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-5fcfd016426b4a219518881a6c43480e2023-03-09T12:29:07ZengCambridge University PressBJPsych Open2056-47242021-07-01710.1192/bjo.2021.953Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9)Phillippa Harrison0Syndi Walton1Diede Fennema2Suqian Duan3Tanja Jaeckle4Kimberley Goldsmith5https://orcid.org/0000-0002-0620-7868Ewan Carr6Mark Ashworth7https://orcid.org/0000-0001-6514-9904Allan. H. Young8https://orcid.org/0000-0003-2291-6952Roland Zahn9https://orcid.org/0000-0002-8447-1453Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKSchool of Population Health and Environmental Sciences, King's College London, UKDepartment of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, UKDepartment of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National Service for Affective Disorders, South London and Maudsley NHS Foundation Trust, UK Background The Patient Health Questionnaire-9 (PHQ-9) is a widely used measure of depression in primary care. It was, however, originally designed as a diagnostic screening tool, and not for measuring change in response to antidepressant treatment. Although the Quick Inventory of Depressive Symptomology (QIDS-SR-16) has been extensively validated for outcome measurement, it is poorly adopted in UK primary care, and, although free for clinicians, has licensing restrictions for healthcare organisation use. Aims We aimed to develop a modified version of the PHQ-9, the Maudsley Modified PHQ-9 (MM-PHQ-9), for tracking symptom changes in primary care. We tested the measure's validity, reliability and factor structure. Method A sample of 121 participants was recruited across three studies, and comprised 78 participants with major depressive disorder and 43 controls. MM-PHQ-9 scores were compared with the QIDS-SR-16 and Clinical Global Impressions improvement scale, for concurrent validity. Internal consistency of the scale was assessed, and principal component analysis was conducted to determine the items’ factor structure. Results The MM-PHQ-9 demonstrated good concurrent validity with the QIDS-SR-16, and excellent internal consistency. Sensitivity to change over a 14-week period was d = 0.41 compared with d = 0.61 on the QIDS-SR-16. Concurrent validity between the paper and mobile app versions of the MM-PHQ-9 was r = 0.67. Conclusions These results indicate that the MM-PHQ-9 is a valid and reliable measure of depressive symptoms in paper and mobile app format, although further validation is required. The measure was sensitive to change, demonstrating suitability for use in routine outcome assessment. https://www.cambridge.org/core/product/identifier/S2056472421009534/type/journal_articleDepressionmeasurementdigital healthantidepressantsprimary care |
| spellingShingle | Phillippa Harrison Syndi Walton Diede Fennema Suqian Duan Tanja Jaeckle Kimberley Goldsmith Ewan Carr Mark Ashworth Allan. H. Young Roland Zahn Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9) BJPsych Open Depression measurement digital health antidepressants primary care |
| title | Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9) |
| title_full | Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9) |
| title_fullStr | Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9) |
| title_full_unstemmed | Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9) |
| title_short | Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9) |
| title_sort | development and validation of the maudsley modified patient health questionnaire mm phq 9 |
| topic | Depression measurement digital health antidepressants primary care |
| url | https://www.cambridge.org/core/product/identifier/S2056472421009534/type/journal_article |
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