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International Journal of Geriatric Psychiatry
Article . 2019 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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Measurement validity of the Patient‐Health Questionnaire‐9 in US nursing home residents

Authors: Emmanuelle Bélanger; Kali S. Thomas; Richard N. Jones; Gary Epstein‐Lubow; Vincent Mor;

Measurement validity of the Patient‐Health Questionnaire‐9 in US nursing home residents

Abstract

ObjectivesThe objective of this study was to assess the measurement properties of the self‐reported Patient Health Questionnaire‐9 (PHQ‐9) and its 10‐item observer version (PHQ‐10OV) among nursing home residents.MethodsWe conducted a retrospective study of Minimum Data Set 3.0 assessments for national cohorts of Medicare Fee‐for‐Service beneficiaries who were newly admitted or incident long‐stay residents in 2014‐2015 at US nursing homes (NHs) certified by the Center for Medicare and Medicaid Services. Statistical analyses included examining internal reliability with McDonald's omega, structural validity with confirmatory factor analysis, and hypothesis testing for expected gender differences and criterion validity with descriptive statistics. The Chronic Condition Warehouse depression diagnoses were used as an administrative reference standard.ResultsBoth the PHQ‐9 and PHQ‐10OV had good internal reliability with omega values above 0.85. The self‐reported scale yielded good model fit for a one‐factor solution, while the PHQ‐10OV had slightly poorer fit and a lower standardized factor loading on the additional irritability item. Both scales appear sufficiently one‐dimensional given that somatic items had higher factor loading on a general depression factor than on a somatic subfactor. We were unable to obtain expected gender differences on the PHQ‐10OV scale. The PHQ‐9 and PHQ‐10OV were both highly specific but had poor sensitivity compared with an administrative reference standard.ConclusionsThe PHQ‐9 appears to be a valid and promising measurement instrument for research about depression among NH residents, while the validity of the PHQ‐10OV should be examined further with a structured psychiatric interview as a stronger criterion standard.

Keywords

Aged, 80 and over, Male, Depressive Disorder, Psychometrics, Reproducibility of Results, Patient Health Questionnaire, Medicare, United States, Nursing Homes, Humans, Female, Factor Analysis, Statistical, Aged, Retrospective Studies

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
38
Top 10%
Top 10%
Top 10%
bronze