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A cutoff score of 7 or higher on the PHQ-9 had a sensitivity of 0.86 and a specificity of 0.86. Conclusions: In the general Chinese population, the Chinese version of the PHQ-9 is a valid and efficient tool for screening depression, with a recommended cutoff score of 7 or more.
The Patient Health Questionnaire-4 (PHQ-4) was developed and validated by Kroenke, Spitzer, Williams, Lwe, (2009) in order to address the fact that anxiety and depression are two of the most prevalent illnesses among the general population.
We also evaluated the accuracy of the PHQ-4 cut-off scores by comparing the them with the screeners full scales (i.e., PHQ-9 and GAD-7). Using the cutoff scores of the screeners, we also estimated the prevalence rates of depression and anxiety. The PHQ-4 has good internal reliability (Cronbachs = 0.82).
Results: The PHQ-2 items showed good reliability (intraclass correlation coefficient=0.92). Quality of life, as reflected by subscale scores for four WHO-QOL domains, was docHubly lower among patients with increasing PHQ-2 scores demonstrating good construct validity.
We also evaluated the accuracy of the PHQ-4 cut-off scores by comparing the them with the screeners full scales (i.e., PHQ-9 and GAD-7). Using the cutoff scores of the screeners, we also estimated the prevalence rates of depression and anxiety. The PHQ-4 has good internal reliability (Cronbachs = 0.82).
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The PHQ-4 has been reported to have a Cronbachs of 0.75 for all scales [1,2].
Patients who screen positive should be further evaluated with the PHQ-9 to determine whether they meet criteria for a depressive disorder. The PHQ-2 has been validated in 3 studies in which it showed wide variability in sensitivity (Gilbody, Richards, Brealey, and Hweitt, 2007).
An elevated PHQ4 score is not diagnostic, but is, instead, an indicator for further inquiry to establish the presence or absence of depression and/or anxiety warranting treatment.

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