Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China
Abstract Background Patient Health Questionnaire (PHQ-9) and PHQ-2 are commonly used screening tools for depression but have not been validated in Chronic obstructive pulmonary disease (COPD) patients. We aimed to validate PHQ-9 and PHQ-2 among COPD patients in China. Methods Stable COPD patients we...
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2025-07-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-07052-3 |
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| author | Meishan Liu Yuhan Chang Dong Wang Jiexin Fang Shannon Carson Boyu Li Yongdong Hu Kewu Huang |
| author_facet | Meishan Liu Yuhan Chang Dong Wang Jiexin Fang Shannon Carson Boyu Li Yongdong Hu Kewu Huang |
| author_sort | Meishan Liu |
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| description | Abstract Background Patient Health Questionnaire (PHQ-9) and PHQ-2 are commonly used screening tools for depression but have not been validated in Chronic obstructive pulmonary disease (COPD) patients. We aimed to validate PHQ-9 and PHQ-2 among COPD patients in China. Methods Stable COPD patients were assessed using a PHQ-9 questionnaire and then assessed by a senior psychiatrist to confirm the diagnosis of major depressive disorder (MDD) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Receiver operating characteristic curve analysis was performed to validate the PHQ-9/PHQ-2. Results Out of 265 COPD patients, 11.7% were diagnosed with MDD. The Cronbach’s α-coefficient for PHQ-9 was 0.751. Both PHQ-9 and PHQ-2 showed good correlations with COPD symptoms and quality of life. The AUC values of PHQ-9 and PHQ-2 were 0.848 and 0.736, respectively, for identifying MDD. Based on the highest Youden index, the optimal cut-off scores were PHQ-9 ≥ 7 and PHQ-2 ≥ 2, with a sensitivity of 74.2% and 58.1% and specificity of 89.7% and 89.3%, respectively. Conclusion PHQ-9 score ≥ 7 and PHQ-2 score ≥ 2 should be used as the optimal cut-offs for COPD patients in China. PHQ-9 is a valid tool for detecting MDD in COPD patients, while PHQ-2 (score < 2) is more useful for quickly excluding MDD. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Psychiatry |
| spelling | doaj-art-bc4d559bf14f44a0ba555eaec61ad8502025-08-20T04:01:41ZengBMCBMC Psychiatry1471-244X2025-07-012511910.1186/s12888-025-07052-3Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in ChinaMeishan Liu0Yuhan Chang1Dong Wang2Jiexin Fang3Shannon Carson4Boyu Li5Yongdong Hu6Kewu Huang7Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical UniversityUniversity of North Carolina Chapel HillDepartment of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical UniversityDepartment of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical UniversityAbstract Background Patient Health Questionnaire (PHQ-9) and PHQ-2 are commonly used screening tools for depression but have not been validated in Chronic obstructive pulmonary disease (COPD) patients. We aimed to validate PHQ-9 and PHQ-2 among COPD patients in China. Methods Stable COPD patients were assessed using a PHQ-9 questionnaire and then assessed by a senior psychiatrist to confirm the diagnosis of major depressive disorder (MDD) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Receiver operating characteristic curve analysis was performed to validate the PHQ-9/PHQ-2. Results Out of 265 COPD patients, 11.7% were diagnosed with MDD. The Cronbach’s α-coefficient for PHQ-9 was 0.751. Both PHQ-9 and PHQ-2 showed good correlations with COPD symptoms and quality of life. The AUC values of PHQ-9 and PHQ-2 were 0.848 and 0.736, respectively, for identifying MDD. Based on the highest Youden index, the optimal cut-off scores were PHQ-9 ≥ 7 and PHQ-2 ≥ 2, with a sensitivity of 74.2% and 58.1% and specificity of 89.7% and 89.3%, respectively. Conclusion PHQ-9 score ≥ 7 and PHQ-2 score ≥ 2 should be used as the optimal cut-offs for COPD patients in China. PHQ-9 is a valid tool for detecting MDD in COPD patients, while PHQ-2 (score < 2) is more useful for quickly excluding MDD.https://doi.org/10.1186/s12888-025-07052-3Chronic obstructive pulmonary diseaseMajor depressive disorderPHQ-9PHQ-2ScreeningValidation |
| spellingShingle | Meishan Liu Yuhan Chang Dong Wang Jiexin Fang Shannon Carson Boyu Li Yongdong Hu Kewu Huang Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China BMC Psychiatry Chronic obstructive pulmonary disease Major depressive disorder PHQ-9 PHQ-2 Screening Validation |
| title | Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China |
| title_full | Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China |
| title_fullStr | Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China |
| title_full_unstemmed | Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China |
| title_short | Validation of the patient health questionnaire (PHQ)-9 and PHQ-2 in patients with COPD in China |
| title_sort | validation of the patient health questionnaire phq 9 and phq 2 in patients with copd in china |
| topic | Chronic obstructive pulmonary disease Major depressive disorder PHQ-9 PHQ-2 Screening Validation |
| url | https://doi.org/10.1186/s12888-025-07052-3 |
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