The validity of a depression screening tool modified for use with Aboriginal and Torres Strait Islander people.
OBJECTIVE
To assess the reliability and validity of a depression screening tool--the PHQ-9Pfizer Inc. modified for use with Aboriginal and Torres Strait Islander people. We also sought to determine the prevalence of depression in a sample of Indigenous people with ischaemic heart disease (IHD).


METHODS
The modified PHQ-9 was administered to a sample of Indigenous people with IHD by an Aboriginal Health Worker (AHW). Tool results were then compared with the results of a psychiatric diagnostic interview conducted by a medical practitioner. Thirty four IHD patients attending an Aboriginal Community Controlled Health Service (ACCHS) in Darwin in 2006 and 2007 participated in the study. The modified PHQ-9's sensitivity, specificity, positive and negative predictive value were calculated for major and minor depression. Chronbach's alpha of the screening test was calculated to measure internal consistency. The prevalence of depression in the study group was also determined.


RESULTS
The prevalence of major depression in the sample was 15.4% (95% CI 7.2%-29.7%). When assessing for major depression the modified PHQ-9 was 80% sensitive (95% CI 66.4-93.6%) and 71.4% (95% CI 56.0-86.8%) specific. A 'mini' version of the modified PHQ-9 demonstrated 100% sensitivity (95% CI 100%-100%) and 12.5% specificity (95% CI 7.0% -25.7%) Chronbach's alpha was 0.8.


CONCLUSIONS
The modified PHQ-9 and the mini-tool, showed promise in this setting. Further investigation with a larger number of Aboriginal and Torres Strait Islander participants is warranted.


CONCLUSIONS
This study has implications both for the Medicare funded Aboriginal Adult Health Checks and for program planning for Aboriginal IHD patients.
Esler
Danielle
D
Danila Diba Health Service, Northern Territory, Flinders University, South Australia [corrected]
Johnston
Fay
F
Thomas
David
D
Davis
Bruce
B
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires