title: Screening for depression with a brief questionnaire in a primary care setting: validation of the two questions with help question (Malay version).
abstract: OBJECTIVE
  To determine the diagnostic accuracy of the two questions with help question (TQWHQ) in the Malay language. The two questions are case-finding questions on depression, and a question on whether help is needed was added to increase the specificity of the two questions.
  
  
  METHODS
  This cross sectional validation study was conducted in a government funded primary care clinic in Malaysia. The participants included 146 consecutive women patients receiving no psychotropic drugs and who were Malay speakers. The main outcome measures were sensitivity, specificity, and likelihood ratios of the two questions and help question.
  
  
  RESULTS
  The two questions showed a sensitivity of 99% (95% confidence interval 88% to 99.9%) and a specificity of 70% (62% to 78%), respectively. The likelihood ratio for a positive test was 3.3 (2.5 to 4.5) and the likelihood ratio for a negative test was 0.01 (0.00 to 0.57). The addition of the help question to the two questions increased the specificity to 95% (89% to 98%).
  
  
  CONCLUSIONS
  The two qeustions on depression detected most cases of depression in this study. The questions have the advantage of brevity. The addition of the help question increased the specificity of the two questions. Based on these findings, the TQWHQ can be strongly recommended for detection of depression in government primary care clnics in Malaysia. Translation did not apear to affect the validity of the TQWHQ.
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia. sherina@putra.upm.edu.my
authors.forename: Sherina
authors.initials: S
authors.lastname: Mohd-Sidik
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
authors.forename: Felicity
authors.initials: F
authors.lastname: Goodyear-Smith
authors.forename: Azhar M D
authors.initials: AM
authors.lastname: Zain
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008296:Malaysia; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult