Comparative validity and responsiveness of PHQ-ADS and other composite anxiety-depression measures.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 03 2019
Historique:
received: 13 09 2018
revised: 20 11 2018
accepted: 24 12 2018
pubmed: 2 1 2019
medline: 2 4 2019
entrez: 2 1 2019
Statut: ppublish

Résumé

Composite measures that assess the overall burden of anxiety and depressive symptoms have been infrequently evaluated in the same study. The objective of this study was to compare the validity and responsiveness of the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) and other composite anxiety-depression measures. The sample comprised 256 primary care patients enrolled in a telecare trial of chronic musculoskeletal pain and comorbid depression and/or anxiety. Measures included the PHQ-ADS; the 8-item and 4-item depression and anxiety scales from the PROMIS profiles; the PHQ-anxiety-depression scale (PHQ-4); the SF-36 Mental Health scale; and the SF-12 Mental Component Summary scale. Correlations among these measures and health-related quality of life measures were examined. Responsiveness was evaluated by standardized response means, area under the curve (AUC) analyses, and treatment effect sizes in the trial. Convergent and construct validity was supported by strong correlations of the composite depression-anxiety measures with one another and moderate correlations with health-related quality of life measures, respectively. All composite measures differentiated patients who were better at 3 months, whereas the PHQ-ADS and PHQ-4 also distinguished the subgroup that had worsened. AUCs for composite measures were generally similar, whereas treatment effect sizes were largest for the PHQ-ADS. The study sample was predominantly male veterans enrolled from primary care who had chronic musculoskeletal pain and moderate levels of depression and anxiety. Composite depression and anxiety scales are valid and responsive measures that may be useful as outcomes in research and clinical practice.

Sections du résumé

BACKGROUND
Composite measures that assess the overall burden of anxiety and depressive symptoms have been infrequently evaluated in the same study. The objective of this study was to compare the validity and responsiveness of the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) and other composite anxiety-depression measures.
METHODS
The sample comprised 256 primary care patients enrolled in a telecare trial of chronic musculoskeletal pain and comorbid depression and/or anxiety. Measures included the PHQ-ADS; the 8-item and 4-item depression and anxiety scales from the PROMIS profiles; the PHQ-anxiety-depression scale (PHQ-4); the SF-36 Mental Health scale; and the SF-12 Mental Component Summary scale. Correlations among these measures and health-related quality of life measures were examined. Responsiveness was evaluated by standardized response means, area under the curve (AUC) analyses, and treatment effect sizes in the trial.
RESULTS
Convergent and construct validity was supported by strong correlations of the composite depression-anxiety measures with one another and moderate correlations with health-related quality of life measures, respectively. All composite measures differentiated patients who were better at 3 months, whereas the PHQ-ADS and PHQ-4 also distinguished the subgroup that had worsened. AUCs for composite measures were generally similar, whereas treatment effect sizes were largest for the PHQ-ADS.
LIMITATIONS
The study sample was predominantly male veterans enrolled from primary care who had chronic musculoskeletal pain and moderate levels of depression and anxiety.
CONCLUSIONS
Composite depression and anxiety scales are valid and responsive measures that may be useful as outcomes in research and clinical practice.

Identifiants

pubmed: 30599366
pii: S0165-0327(18)32041-X
doi: 10.1016/j.jad.2018.12.098
pii:
doi:

Types de publication

Comparative Study Journal Article Research Support, U.S. Gov't, Non-P.H.S. Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

437-443

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Kurt Kroenke (K)

VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, IN, United States; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States; Regenstrief Institute, Inc., Indianapolis, IN, United States. Electronic address: kkroenke@regenstrief.org.

Fitsum Baye (F)

Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States.

Spencer G Lourens (SG)

Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States.

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Classifications MeSH