Validation of the Thai version of the Patient Health Questionnaire for Adolescents (PHQ-A) in school setting
Keywords:
adolescents, depression, patient health questionnaire for adolescents (PHQ-A), schoolAbstract
Objective: To examine the psychometric properties of the Thai version of the patient health questionnaire for adolescent (PHQ-A) in school settings.
Methods: This study was the second phase of the national survey on prevalence of depression and suicidal risks in 5,345 students aged 11 - 19 years old. A total of 292 subjects at risk of depression (PHQ-A ≥ 10) and 130 randomly selected controls (10% of those with negative screening results) in central region in the first phase were re-evaluated for depression by using the PHQ-A, and interviewed for clinical diagnosis by the child and adolescent psychiatrists. The validity and reliability tests of the PHQ-A were restricted to 389 subjects (69 depressive and 320 non-depressive subjects), excluding those diagnosed with anxiety or adjustment disorders.
Results: The PHQ-A has good internal consistency with Cronbach’s alpha coefficient of 0.88. According to ROC analysis compared to clinical diagnosis, the area under the curve (AUC) was 0.91 (SD = 0.02, 95% CI 0.88 - 0.94). The optimal cut-off point with preferable psychometric properties was 10 (sensitivity = 93% and specificity = 77%). Approximately 86% of the depressive group had the PHQ-A scores within moderate to severe level (10 - 19), while 77.5% of the non-depressive group had the PHQ-A scores lower than 10.
Conclusion: The Thai version of the PHQ-A is suitable for screening and monitoring depression in adolescents in school settings. The optimal cut-off point of 10 or higher is suggested, though it could be adjusted depending on the purpose of use.
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