Please use this identifier to cite or link to this item: https://hdl.handle.net/1959.11/16456
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dc.contributor.authorCholera, Ren
dc.contributor.authorGaynes, BNen
dc.contributor.authorPence, BWen
dc.contributor.authorBassett, Jen
dc.contributor.authorQangule, Nen
dc.contributor.authorMacPhail, Catherineen
dc.contributor.authorBernhardt, Sen
dc.contributor.authorPettifor, Aen
dc.contributor.authorMiller, WCen
dc.date.accessioned2015-01-13T10:15:00Z-
dc.date.issued2014-
dc.identifier.citationJournal of Affective Disorders, v.167, p. 160-166en
dc.identifier.issn1573-2517en
dc.identifier.issn0165-0327en
dc.identifier.urihttps://hdl.handle.net/1959.11/16456-
dc.description.abstractBackground: Integration of depression screening into primary care may increase access to mental health services in sub-Saharan Africa, but this approach requires validated screening instruments. We sought to validate the Patient Health Questionnaire-9 (PHQ-9) as a depression screening tool at a high HIV-burden primary care clinic in Johannesburg, South Africa. Methods: We conducted a validation study of an interviewer-administered PHQ-9 among 397 patients. Sensitivity and specificity of the PHQ-9 were calculated with the Mini International Neuropsychiatric Interview (MINI) as the reference standard; receiver operating characteristic (ROC) curve analyses were performed. Results: The prevalence of depression was 11.8%. One-third of participants tested positive for HIV. HIV-infected patients were more likely to be depressed (15%) than uninfected patients (9%; p=0.08). Using the standard cutoff score of ≥10, the PHQ-9 had a sensitivity of 78.7% (95% CI: 64.3-89.3) and specificity of 83.4% (95% CI: 79.1-87.2). The area under the ROC curve was 0.88 (95% CI: 0.83-0.92). Test performance did not vary by HIV status or language. In sensitivity analyses, reference test bias associated with the MINI appeared unlikely. Limitations: We were unable to conduct qualitative work to adapt the PHQ-9 to this cultural context. Conclusion: This is the first validation study of the PHQ-9 in a primary care clinic in sub-Saharan Africa. It highlights the potential for using primary care as an access point for identifying depressive symptoms during routine HIV testing. The PHQ-9 showed reasonable accuracy in classifying cases of depression, was easily implemented by lay health workers, and is a useful screening tool in this setting.en
dc.languageenen
dc.publisherElsevier BVen
dc.relation.ispartofJournal of Affective Disordersen
dc.titleValidity of the patient health questionnaire-9 to screen for depression in a high-HIV burden primary healthcare clinic in Johannesburg, South Africaen
dc.typeJournal Articleen
dc.identifier.doi10.1016/j.jad.2014.06.003en
dcterms.accessRightsGreenen
dc.subject.keywordsHealth Promotionen
dc.subject.keywordsMental Healthen
local.contributor.firstnameRen
local.contributor.firstnameBNen
local.contributor.firstnameBWen
local.contributor.firstnameJen
local.contributor.firstnameNen
local.contributor.firstnameCatherineen
local.contributor.firstnameSen
local.contributor.firstnameAen
local.contributor.firstnameWCen
local.subject.for2008111712 Health Promotionen
local.subject.for2008111714 Mental Healthen
local.subject.seo2008920410 Mental Healthen
local.subject.seo2008920412 Preventive Medicineen
local.profile.schoolSchool of Rural Medicineen
local.profile.emailcmacphai@une.edu.auen
local.output.categoryC1en
local.record.placeauen
local.record.institutionUniversity of New Englanden
local.identifier.epublicationsrecordune-20150112-165615en
local.publisher.placeNetherlandsen
local.format.startpage160en
local.format.endpage166en
local.url.openhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264106en
local.peerreviewedYesen
local.identifier.volume167en
local.access.fulltextYesen
local.contributor.lastnameCholeraen
local.contributor.lastnameGaynesen
local.contributor.lastnamePenceen
local.contributor.lastnameBassetten
local.contributor.lastnameQanguleen
local.contributor.lastnameMacPhailen
local.contributor.lastnameBernhardten
local.contributor.lastnamePettiforen
local.contributor.lastnameMilleren
dc.identifier.staffune-id:cmacphaien
local.profile.orcid0000-0002-0614-0157en
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.profile.roleauthoren
local.identifier.unepublicationidune:16693en
local.identifier.handlehttps://hdl.handle.net/1959.11/16456en
dc.identifier.academiclevelAcademicen
local.title.maintitleValidity of the patient health questionnaire-9 to screen for depression in a high-HIV burden primary healthcare clinic in Johannesburg, South Africaen
local.output.categorydescriptionC1 Refereed Article in a Scholarly Journalen
local.search.authorCholera, Ren
local.search.authorGaynes, BNen
local.search.authorPence, BWen
local.search.authorBassett, Jen
local.search.authorQangule, Nen
local.search.authorMacPhail, Catherineen
local.search.authorBernhardt, Sen
local.search.authorPettifor, Aen
local.search.authorMiller, WCen
local.uneassociationUnknownen
local.identifier.wosid000341335700025en
local.year.published2014en
local.subject.for2020420603 Health promotionen
local.subject.for2020420313 Mental health servicesen
local.subject.seo2020200409 Mental healthen
local.subject.seo2020200412 Preventive medicineen
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