title: Validation of the nine-item Patient Health Questionnaire to screen for major depression in a Chinese primary care population.
abstract: BACKGROUND
  The aim of this study was to examine the reliability and validity of the nine-item Patient Health Questionnaire (PHQ-9) for screening depression in Chinese primary care settings.
  
  
  METHODS
  In 100 randomly selected primary care clinics (PCC) of Hangzhou city, we recruited 2,639 patients (aged ≥18 years) and applied the PHQ-9 to screen for depression. Then, 280 of them were further interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual Disorders (SCID) for the diagnosis of major depression. Statistical analysis of the demographic data, reliability, validity and receiver-operator curve were performed.
  
  
  RESULTS
  The mean administration time was 7 minutes, and the Cronbach's α was 0.89. The optimal cutoff score of 10 on the PHQ-9 revealed a sensitivity of 0.87, specificity of 0.81, and positive likelihood ratio of 5.04. The area under the receiver-operator curve in this study was 0.91 (95% confidence interval, 0.87-0.94).
  
  
  CONCLUSIONS
  The PHQ-9 performs well and has acceptable psychometric properties for screening of patients with depression in a Chinese primary care population.
authors.affiliation: Department of Psychology, Zhejiang University, Hangzhou, China. csl@zju.edu.cn
authors.forename: Shulin
authors.initials: S
authors.lastname: Chen
authors.forename: Yu
authors.initials: Y
authors.lastname: Fang
authors.forename: Helen
authors.initials: H
authors.lastname: Chiu
authors.forename: Hainan
authors.initials: H
authors.lastname: Fan
authors.forename: Tao
authors.initials: T
authors.lastname: Jin
authors.forename: Yeates
authors.initials: Y
authors.lastname: Conwell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China / Q000208:ethnology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012372:ROC Curve; D011795:Surveys and Questionnaires / Q000592:standards; D055815:Young Adult
keywords: Chinese; PHQ-9; depression; primary care