Accuracy of PHQ-9 against psychiatric diagnosis for depression among people living with HIV: A multicounty cross-sectional study.

Journal: AIDS (London, England)

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Affiliated Institutions:  Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR , Research Institute for Sustainable Development (IRD) EMR , Bordeaux Population Health Centre, Bordeaux, France. Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. Clinical Research Education and Consultancy, Yaoundé, Cameroon. Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA. Centre de Traitement Ambulatoire, Brazzaville, Republic of Congo. Department of Psychiatry, Jamot Hospital, Yaoundé, Cameroon. Centre médical de suivi des donneurs de sang (CNTSCI), Abidjan, Côte d'Ivoire. Service de maladies infectieuses et tropicales, CHNU de Fann, Dakar, Senegal. Moi Teaching and Referral Hospital, Eldoret, Kenya. Department of Mental Health and Behavioural Sciences, Moi University School of Medicine, Eldoret, Kenya.

Abstract summary 

The aim of this study was to assess the performance of the 9-item Patient Health questionnaire (PHQ-9) against psychiatrist diagnosis in PLWH.Cross-sectional analysis of data collected between January 2018 and July 2022 across five sites in Cameroon, Cote d'Ivoire, Kenya, Senegal, and the Republic of Congo. Participants were ≥18 years and receiving HIV care at the participating site. PHQ-9 was administered by study staff followed by a psychiatrist's evaluation within 3 days.Overall, 778 participants with complete data were included: 297 (38.2%) in Cameroon, 132 (17.0%) in Congo, 148 (19.0%) in Cote d'Ivoire, 98 (12.6%) in Kenya, and 103 (13.2%) in Senegal. The area under the curve for PHQ-9 score was generally high ranging from 0.935 (95% CI: 0.893, 0.977) in Cote d'Ivoire to 0.768 (95% CI: 0.589, 0.947) in Congo. However, for the common cut-off score ≥10, sensitivity was low: 50% or lower in Cameroon, Congo and Senegal, 66.7% in Kenya and 70.6% in Cote d'Ivoire. But negative predictive values (NPV) were high: 98.9% (95% CI: 96.9%, 99.8%) in Cameroon, 96.1 (95% CI: 91.1, 98.7) in Cote d'Ivoire, 96.3% (95% CI: 89.7%, 99.2%) in Kenya, 95.7% (95% CI: 90.2%, 98.6%) in Congo, and 89.0% (95% CI: 81.2%, 94.4%) in Senegal.Across all countries, PHQ-9 score ≥10 performed very poorly (low sensitivity) as a tool to identify psychiatrist diagnosed depression. However, the observed high NPV suggests it can be used to rule out depression.

Authors & Co-authors:  Yotebieng Marcel M Zotova Natalia N Bernard Charlotte C Goodrich Suzanne S Awoh Ajeh Rogers AR Watnick Dana D Nsonde Dominique Mahambu DM Moungang Elodie Flore Tchiengang EFT Noumedem Julie Laure Nguemo JLN Mbongo'o Guy Calvin Nko'o GCN Minga Albert A Seydi Moussa M Gandou Paul P Kwobah Edith Kamaru EK Atwoli Lukoye L Jaquet Antoine A Wools-Kaloustian Kara K Anastos Kathryn K

Study Outcome 

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Citations : 
Authors :  19
Identifiers
Doi : 10.1097/QAD.0000000000003963
SSN : 1473-5571
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Senegal
Publication Country
England