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2019, Number 1

Salud Mental 2019; 42 (1)

Evaluation of the Brazilian version of Patient Health Questionnaire (PHQ-9) in Quilombola population using the Item Response Theory

Barroso MS, Souto MAP, Aparecida SM, Crosland GMD
Full text How to cite this article

Language: English
References: 64
Page: 43-50
PDF size: 671.99 Kb.


Key words:

Depression, psychometrics, Patient Health Questionnaire, Brazil.

ABSTRACT

Introduction. The Patient Health Questionnaire (PHQ-9) is one of the most validated tools used to detect depressive episodes in Brazil. Objective. This study investigates the psychometric properties of the PHQ-9 using the Item Response Theory. Method. We used the gradual response model to assess depression in 764 residents of Brazilian rural communities of descended from slaves (quilombos) from the county of Vitória da Conquista, state of Bahia, Brazil, who had responded to PHQ-9. We estimated the parameters for item discrimination and difficulty. Results. The items of the PHQ-9 showed the ability to discriminate from moderate to very high. The items evaluating thoughts of hurting oneself and death showed the greatest discrimination while feeling depressed showed the lowest discrimination. Discussion and conclusion. The Item Response Theory enables advances in the analysis of the psychometric properties of the screening tools assessing depression, and indicates that PHQ-9 can be used in rural populations in Brazil.


REFERENCES

  1. Adler, M., Hetta, J., Isacsson, G., & Brodin, U. (2012). An item response theory evaluation of three depression assessment instruments in a clinical sample. BMC Medical Research Methodology, 12(1), 84-96. doi: 10.1186/1471-2288-12-84

  2. American Psychiatric Association. (2014). Diagnostic and Statistical Manual of Mental Disorders - DSM-5. Arlington: American Psychiatric Publishing.

  3. Anjos, R. S. A. & Cipriano, A. (2007). The communities in the national territory. In: R. S. A. Anjos & A. Cipriano (Ed.), Quilombolas: traditions and culture of resistance. São Paulo: Aori Comunicação.

  4. Aros, M. S. & Yoshida, E. M. P. (2009). Depression Studies: Assessment tools and gender. Boletim de psicologia, 59(130), 61-76.

  5. Baker, F. B. (2001). The basics of item response theory. Wisconsin: ERIC Clearinghouse on Assessment and Evaluation. Castro, S. M. J., Cúri, M. I, Torman, V. B. L., & Riboldi, J. (2015). Differential Functioning of the Item in the Beck Depression Inventory. Revista Brasileira de Epidemiologia, 18(1), 54-67. doi: 10.1590/1980-5497201500010005

  6. Castro, S. M. J., Trentini, C., & Riboldi, J. (2010). Item Response Theory applied to the Beck Depression Inventory. Revista Brasileira de Epidemiologia, 13(3), 487-501. doi: 10.1590/S1415-790X2010000300012

  7. Couto, G. & Primi, R. (2011). Item response theory (ITR): Elementary concepts for dicotomic items models. Bol. psicol [online]. 61(134), 1-15. Retrieved from: http://pepsic.bvsalud.org/pdf/bolpsi/v61n134/v61n134a02.pdf

  8. Dibal, N. P., Okafor, R., & Dallah, H. (2017). Challenges and implications of missing data on the validity of inferences and options for choosing the right strategy in handling them. International Journal of Statistical Distributions and Applications, 3(4), 87-94.

  9. Embretson, S. E. & Reise, S. P. (2013). Item response theory for psychologists. New York: Psychology Press. 9. Federal Council of Psychology. (2003). CFP Resolution No. 002/2003. Retrieved from: http://site.cfp.org.br/wp-content/uploads/2003/03/resolucao2003_02_ Anexo.pdf

  10. Forkmann, T., Gauggel, S., Spangenberg, L., Brähler, E., & Glaesmer, H. (2013). Dimensional assessment of depressive severity in the elderly general population: Psychometric evaluation of the PHQ-9 using Rasch Analysis. Journal of affective disorders, 148(2-3), 323-330. doi: 10.1016/j.jad.2012.12.019

  11. Gomes, K. O., Reis, E. A., Guimarães, M. D. C., & Cherchiglia, M. L. (2013). Use of health services by quilombo communities in southwest Bahia State, Brazil. Cadernos de saude publica, 29(9), 1829-1842. doi: 10.1590/0102- 311X00151412

  12. Kendel, F., Wirtz, M., Dunkel, A., Lehmkuhl, E., Hetzer, R., & Regitz-Zagrosek, V. (2010). Screening for depression: Rasch analysis of the dimensional structure of the PHQ-9 and the HADS-D. Journal of Affective Disorders, 122(3), 241-246. doi: 10.1016/j.jad.2009.07.004

  13. Kessler, R. C. & Bromet, E. (2013). The epidemiology of depression across cultures. Annual review of public health, 34, 119-138. doi: 10.1146/annurevpublhealth- 031912-114409

  14. Kung, S., Alarcon, R. D., Williams, M. D., Poppe, K. A., Moore, M. J., & Frye, M. A. (2013). Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) depression measures in an integrated mood disorders practice. Journal of affective disorders, 145(3), 341-343. doi: 10.1016/j.jad.2012.08.017

  15. Lopez, M. R. A., Ribeiro, J. P., Ores, L. C., Jansen, K., Souza, L. D. M., Pinheiro, R. T., & Silva, R. A. (2011). Depressão e qualidade de vida em jovens de 18 a 24 anos no sul do Brasil. Revista de Psiquiatria do Rio Grande do Sul, 33(2), 103- 108. doi: 10.1590/S0101-81082011005000001

  16. Manea, L., Gilbody, S., & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): A meta-analysis. CMAJ, 184(3), 191-196. doi: 10.1503/cmaj.110829

  17. Máximo, G. C. (2010). Aspectos sociodemográficos da depressão e utilização de serviços de saúde no Brasil (tese de doutoramento). Universidade Federal de Minas Gerais, Belo Horizonte.

  18. Meredith, W. M. & Teresi, J. A. (2006). An essay on measurement and factorial invariance. Medical Care, 44(3), 69-77. doi: 10.1097/01. mlr.0000245438.73837.89

  19. Oliveira, S. K. M., Pereira, M. M., Guimarães, A. L. S., & Caldeira, A. P. (2015). Self-perception of health in quilombolas from northern Minas Gerais, Brazil. Ciencia & Saude Coletiva, 20(9), 2879-2890. doi: 10.1590/1413- 81232015209.20342014

  20. Osório, F. L., Mendes, A. V., Crippa, J. A., & Loureiro, S.R. (2009). Study of the discriminative validity of the PHQ-9 and PHQ-2 in a sample of Brazilian women in the context of primary health care. Perspectives in Psychiatric Care, 45(3), 216-227. doi: 10.1111/j.1744-6163.2009.00224.x

  21. Oswaldo Cruz Fundation & Institute of Geography and Statistics. (2013). National Health Survey. Retrieved from: http://www.pns.icict.fiocruz.br

  22. Peluso, E. T. P & Blay, S. L. (2008). Percepção da depressão pela população da cidade de São Paulo. Revista de Saúde Pública, 42 (1), 41- 48. doi: 10.1590/S0034- 89102008000100006

  23. Reckase, M. D. (1979). Unifactor latent trait models applied to multifactor tests: results and aplications. Journal of Educacional Statistics, 4(3), 207-230.

  24. Samejima, F. (1969). Estimation of latente ability using a response pattern of graded scores. Psychometric Monograph, Nº 17. Richmond, VA: Psychometric Society. Retrieved from: http://www.psychometrika.org/journal/online/MN17.pdf

  25. Santos, I. S., Tavares, B. F., Munhoz, T. N., Almeida, L. S. P. D., Silva, N. T. B. D., Tams, B. D., ... & Matijasevich, A. (2013). Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults of the general population. Cadernos de Saúde Pública, 29(8), 1533-1543. doi: 10.1590/0102- 311X00144612

  26. Sartes, L. M. A. & Souza-Formigoni, M. L. O. (2013). Advances in psychometry: from the Classical Theory of Tests to the Theory of Response to Item. Psicologia: Reflexão e Crítica, 26(2), 241-250. doi: 10.1590/S0102-79722013000200004

  27. Stopa, S. R., Malta, D. C., Oliveira, M. M., Lopes, C. S. L., Menezes, P. R., & Kinoshita, R. T. (2015). Prevalence of self-report of depression in Brazil: results of the National Health Survey, 2013. Revista Brasileira de Epidemiologia, 18(2), 170-180. doi: 10.1590/1980-5497201500060015

  28. World Health Organization (WHO). (2012). Depression, A Hidden Burden: Let’s recognize and deal with it. Retrieved from: http://www.who.int/mental_health/ management/depression/flyer_depression_2012.pdf

  29. World Health Organization (WHO). (2017). Depression and Other Common Mental Disorders Global Health Estimates. Retrieved from: http://apps.who.int/iris/ bitstream/10665/254610/1/WHO-MSD-MER-2017.2-eng.pdf

  30. Zhao, Y., Chan, W., & Lo, B. C. Y. (2017). Comparing five depression measures in depressed Chinese patients using item response theory: an examination of item properties, measurement precision and score comparability. Health and Quality of Life Outcomes, 15(1), 60-74. doi: 10.1186/s12955-017-0631-y

  31. Zhao, Y., Chan, W., & Lo, B. C. Y. (2017). Comparing five depression measures in depressed Chinese patients using item response theory: an examination of item properties, measurement precision and score comparability. Health and Quality of Life Outcomes, 15(1), 60-74. doi: 10.1186/s12955-017-0631-y

  32. Zukowsky-Tavares, C. (2013). Teoria da Resposta ao Item: uma análise crítica dos pressupostos epistemológicos. Estudos em Avaliação Educacional, 24(54), 56- 76.

  33. Adler, M., Hetta, J., Isacsson, G., & Brodin, U. (2012). An item response theory evaluation of three depression assessment instruments in a clinical sample. BMC Medical Research Methodology, 12(1), 84-96. doi: 10.1186/1471-2288-12-84

  34. American Psychiatric Association. (2014). Diagnostic and Statistical Manual of Mental Disorders - DSM-5. Arlington: American Psychiatric Publishing.

  35. Anjos, R. S. A. & Cipriano, A. (2007). The communities in the national territory. In: R. S. A. Anjos & A. Cipriano (Ed.), Quilombolas: traditions and culture of resistance. São Paulo: Aori Comunicação.

  36. Aros, M. S. & Yoshida, E. M. P. (2009). Depression Studies: Assessment tools and gender. Boletim de psicologia, 59(130), 61-76.

  37. Baker, F. B. (2001). The basics of item response theory. Wisconsin: ERIC Clearinghouse on Assessment and Evaluation. Castro, S. M. J., Cúri, M. I, Torman, V. B. L., & Riboldi, J. (2015). Differential Functioning of the Item in the Beck Depression Inventory. Revista Brasileira de Epidemiologia, 18(1), 54-67. doi: 10.1590/1980-5497201500010005

  38. Castro, S. M. J., Trentini, C., & Riboldi, J. (2010). Item Response Theory applied to the Beck Depression Inventory. Revista Brasileira de Epidemiologia, 13(3), 487-501. doi: 10.1590/S1415-790X2010000300012

  39. Couto, G. & Primi, R. (2011). Item response theory (ITR): Elementary concepts for dicotomic items models. Bol. psicol [online]. 61(134), 1-15. Retrieved from: http://pepsic.bvsalud.org/pdf/bolpsi/v61n134/v61n134a02.pdf

  40. Dibal, N. P., Okafor, R., & Dallah, H. (2017). Challenges and implications of missing data on the validity of inferences and options for choosing the right strategy in handling them. International Journal of Statistical Distributions and Applications, 3(4), 87-94.

  41. Embretson, S. E. & Reise, S. P. (2013). Item response theory for psychologists. New York: Psychology Press. 9. Federal Council of Psychology. (2003). CFP Resolution No. 002/2003. Retrieved from: http://site.cfp.org.br/wp-content/uploads/2003/03/resolucao2003_02_ Anexo.pdf

  42. Forkmann, T., Gauggel, S., Spangenberg, L., Brähler, E., & Glaesmer, H. (2013). Dimensional assessment of depressive severity in the elderly general population: Psychometric evaluation of the PHQ-9 using Rasch Analysis. Journal of affective disorders, 148(2-3), 323-330. doi: 10.1016/j.jad.2012.12.019

  43. Gomes, K. O., Reis, E. A., Guimarães, M. D. C., & Cherchiglia, M. L. (2013). Use of health services by quilombo communities in southwest Bahia State, Brazil. Cadernos de saude publica, 29(9), 1829-1842. doi: 10.1590/0102- 311X00151412

  44. Kendel, F., Wirtz, M., Dunkel, A., Lehmkuhl, E., Hetzer, R., & Regitz-Zagrosek, V. (2010). Screening for depression: Rasch analysis of the dimensional structure of the PHQ-9 and the HADS-D. Journal of Affective Disorders, 122(3), 241-246. doi: 10.1016/j.jad.2009.07.004

  45. Kessler, R. C. & Bromet, E. (2013). The epidemiology of depression across cultures. Annual review of public health, 34, 119-138. doi: 10.1146/annurevpublhealth- 031912-114409

  46. Kung, S., Alarcon, R. D., Williams, M. D., Poppe, K. A., Moore, M. J., & Frye, M. A. (2013). Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) depression measures in an integrated mood disorders practice. Journal of affective disorders, 145(3), 341-343. doi: 10.1016/j.jad.2012.08.017

  47. Lopez, M. R. A., Ribeiro, J. P., Ores, L. C., Jansen, K., Souza, L. D. M., Pinheiro, R. T., & Silva, R. A. (2011). Depressão e qualidade de vida em jovens de 18 a 24 anos no sul do Brasil. Revista de Psiquiatria do Rio Grande do Sul, 33(2), 103- 108. doi: 10.1590/S0101-81082011005000001

  48. Manea, L., Gilbody, S., & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): A meta-analysis. CMAJ, 184(3), 191-196. doi: 10.1503/cmaj.110829

  49. Máximo, G. C. (2010). Aspectos sociodemográficos da depressão e utilização de serviços de saúde no Brasil (tese de doutoramento). Universidade Federal de Minas Gerais, Belo Horizonte.

  50. Meredith, W. M. & Teresi, J. A. (2006). An essay on measurement and factorial invariance. Medical Care, 44(3), 69-77. doi: 10.1097/01. mlr.0000245438.73837.89

  51. Oliveira, S. K. M., Pereira, M. M., Guimarães, A. L. S., & Caldeira, A. P. (2015). Self-perception of health in quilombolas from northern Minas Gerais, Brazil. Ciencia & Saude Coletiva, 20(9), 2879-2890. doi: 10.1590/1413- 81232015209.20342014

  52. Osório, F. L., Mendes, A. V., Crippa, J. A., & Loureiro, S.R. (2009). Study of the discriminative validity of the PHQ-9 and PHQ-2 in a sample of Brazilian women in the context of primary health care. Perspectives in Psychiatric Care, 45(3), 216-227. doi: 10.1111/j.1744-6163.2009.00224.x

  53. Oswaldo Cruz Fundation & Institute of Geography and Statistics. (2013). National Health Survey. Retrieved from: http://www.pns.icict.fiocruz.br

  54. Peluso, E. T. P & Blay, S. L. (2008). Percepção da depressão pela população da cidade de São Paulo. Revista de Saúde Pública, 42 (1), 41- 48. doi: 10.1590/S0034- 89102008000100006

  55. Reckase, M. D. (1979). Unifactor latent trait models applied to multifactor tests: results and aplications. Journal of Educacional Statistics, 4(3), 207-230.

  56. Samejima, F. (1969). Estimation of latente ability using a response pattern of graded scores. Psychometric Monograph, Nº 17. Richmond, VA: Psychometric Society. Retrieved from: http://www.psychometrika.org/journal/online/MN17.pdf

  57. Santos, I. S., Tavares, B. F., Munhoz, T. N., Almeida, L. S. P. D., Silva, N. T. B. D., Tams, B. D., ... & Matijasevich, A. (2013). Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults of the general population. Cadernos de Saúde Pública, 29(8), 1533-1543. doi: 10.1590/0102- 311X00144612

  58. Sartes, L. M. A. & Souza-Formigoni, M. L. O. (2013). Advances in psychometry: from the Classical Theory of Tests to the Theory of Response to Item. Psicologia: Reflexão e Crítica, 26(2), 241-250. doi: 10.1590/S0102-79722013000200004

  59. Stopa, S. R., Malta, D. C., Oliveira, M. M., Lopes, C. S. L., Menezes, P. R., & Kinoshita, R. T. (2015). Prevalence of self-report of depression in Brazil: results of the National Health Survey, 2013. Revista Brasileira de Epidemiologia, 18(2), 170-180. doi: 10.1590/1980-5497201500060015

  60. World Health Organization (WHO). (2012). Depression, A Hidden Burden: Let’s recognize and deal with it. Retrieved from: http://www.who.int/mental_health/ management/depression/flyer_depression_2012.pdf

  61. World Health Organization (WHO). (2017). Depression and Other Common Mental Disorders Global Health Estimates. Retrieved from: http://apps.who.int/iris/ bitstream/10665/254610/1/WHO-MSD-MER-2017.2-eng.pdf

  62. Zhao, Y., Chan, W., & Lo, B. C. Y. (2017). Comparing five depression measures in depressed Chinese patients using item response theory: an examination of item properties, measurement precision and score comparability. Health and Quality of Life Outcomes, 15(1), 60-74. doi: 10.1186/s12955-017-0631-y

  63. Zhao, Y., Chan, W., & Lo, B. C. Y. (2017). Comparing five depression measures in depressed Chinese patients using item response theory: an examination of item properties, measurement precision and score comparability. Health and Quality of Life Outcomes, 15(1), 60-74. doi: 10.1186/s12955-017-0631-y

  64. Zukowsky-Tavares, C. (2013). Teoria da Resposta ao Item: uma análise crítica dos pressupostos epistemológicos. Estudos em Avaliação Educacional, 24(54), 56- 76.




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Salud Mental. 2019;42