The PHQ-8 as a measure of current depression in the general population

Kurt Kroenke, Tara W. Strine, Robert L. Spitzer, Janet B.W. Williams, Joyce T. Berry, Ali H. Mokdad

Research output: Contribution to journalArticle

1285 Scopus citations

Abstract

Background: The eight-item Patient Health Questionnaire depression scale (PHQ-8) is established as a valid diagnostic and severity measure for depressive disorders in large clinical studies. Our objectives were to assess the PHQ-8 as a depression measure in a large, epidemiological population-based study, and to determine the comparability of depression as defined by the PHQ-8 diagnostic algorithm vs. a PHQ-8 cutpoint ≥ 10. Methods: Random-digit-dialed telephone survey of 198,678 participants in the 2006 Behavioral Risk Factor Surveillance Survey (BRFSS), a population-based survey in the United States. Current depression as defined by either the DSM-IV based diagnostic algorithm (i.e., major depressive or other depressive disorder) of the PHQ-8 or a PHQ-8 score ≥ 10; respondent sociodemographic characteristics; number of days of impairment in the past 30 days in multiple domains of health-related quality of life (HRQoL). Results: The prevalence of current depression was similar whether defined by the diagnostic algorithm or a PHQ-8 score ≥ 10 (9.1% vs. 8.6%). Depressed patients had substantially more days of impairment across multiple domains of HRQoL, and the impairment was nearly identical in depressed groups defined by either method. Of the 17,040 respondents with a PHQ-8 score ≥ 10, major depressive disorder was present in 49.7%, other depressive disorder in 23.9%, depressed mood or anhedonia in another 22.8%, and no evidence of depressive disorder or depressive symptoms in only 3.5%. Limitations: The PHQ-8 diagnostic algorithm rather than an independent structured psychiatric interview was used as the criterion standard. Conclusions: The PHQ-8 is a useful depression measure for population-based studies, and either its diagnostic algorithm or a cutpoint ≥ 10 can be used for defining current depression.

Original languageEnglish (US)
Pages (from-to)163-173
Number of pages11
JournalJournal of Affective Disorders
Volume114
Issue number1-3
DOIs
StatePublished - Apr 1 2009

Keywords

  • Depression
  • Epidemiology
  • Patient Health Questionnaire
  • Prevalence
  • Psychometrics
  • Quality of life

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

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  • Cite this

    Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009). The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders, 114(1-3), 163-173. https://doi.org/10.1016/j.jad.2008.06.026