Getting it Right

validating a culturally specific screening tool for depression (aPHQ-9) in Aboriginal and Torres Strait Islander Australians

The Getting it Right Collaborative Group

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objectives: To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander people.

    Design: Prospective observational validation study, 25 March 2015 – 2 November 2016.

    Setting, participants: 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions.

    Main outcome measures: Criterion validity of the aPHQ-9, with the depression module of the Mini-International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard.

    Results: 108 of 500 participants (22%; 95% CI, 18–25%) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ-9 algorithm for diagnosing a current major depressive episode was 54% (95% CI, 40–68%), its specificity was 91% (95% CI, 88–94%), with a positive predictive value of 64%. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95% CI, 0.85–0.92); with a cut-point of 10 points its sensitivity was 84% (95% CI, 74–91%) and its specificity 77% (95% CI, 71–83%). The aPHQ-9 was deemed acceptable by more than 80% of participants.

    Conclusions: Indigenous Australians found the aPHQ-9 acceptable as a screening tool for depression. Applying a cut-point of 10 points, the performance characteristics of the aPHQ were good.

    Original languageEnglish
    Pages (from-to)24-30
    Number of pages7
    JournalMedical Journal of Australia
    Volume211
    Issue number1
    Early online date30 Jun 2019
    DOIs
    Publication statusPublished - Jul 2019

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    Interviews
    Validation Studies
    Health Services
    Observational Studies
    Primary Health Care
    Outcome Assessment (Health Care)
    Sensitivity and Specificity
    Health
    Surveys and Questionnaires
    CI 22

    Cite this

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    title = "Getting it Right: validating a culturally specific screening tool for depression (aPHQ-9) in Aboriginal and Torres Strait Islander Australians",
    abstract = "Objectives: To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander people. Design: Prospective observational validation study, 25 March 2015 – 2 November 2016. Setting, participants: 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions. Main outcome measures: Criterion validity of the aPHQ-9, with the depression module of the Mini-International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard. Results: 108 of 500 participants (22{\%}; 95{\%} CI, 18–25{\%}) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ-9 algorithm for diagnosing a current major depressive episode was 54{\%} (95{\%} CI, 40–68{\%}), its specificity was 91{\%} (95{\%} CI, 88–94{\%}), with a positive predictive value of 64{\%}. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95{\%} CI, 0.85–0.92); with a cut-point of 10 points its sensitivity was 84{\%} (95{\%} CI, 74–91{\%}) and its specificity 77{\%} (95{\%} CI, 71–83{\%}). The aPHQ-9 was deemed acceptable by more than 80{\%} of participants. Conclusions: Indigenous Australians found the aPHQ-9 acceptable as a screening tool for depression. Applying a cut-point of 10 points, the performance characteristics of the aPHQ were good.",
    keywords = "Depressive disorders, Indigenous health, Psychometrics",
    author = "{The Getting it Right Collaborative Group} and Hackett, {Maree L.} and Armando Teixeira-Pinto and Sara Farnbach and Nicholas Glozier and Timothy Skinner and Askew, {Deborah A.} and Graham Gee and Alan Cass and Alex Brown",
    year = "2019",
    month = "7",
    doi = "10.5694/mja2.50212",
    language = "English",
    volume = "211",
    pages = "24--30",
    journal = "Medical Journal of Australia",
    issn = "0025-729X",
    publisher = "Australasian Medical Publishing Company",
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    }

    Getting it Right : validating a culturally specific screening tool for depression (aPHQ-9) in Aboriginal and Torres Strait Islander Australians. / The Getting it Right Collaborative Group.

    In: Medical Journal of Australia, Vol. 211, No. 1, 07.2019, p. 24-30.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Getting it Right

    T2 - validating a culturally specific screening tool for depression (aPHQ-9) in Aboriginal and Torres Strait Islander Australians

    AU - The Getting it Right Collaborative Group

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    AU - Teixeira-Pinto, Armando

    AU - Farnbach, Sara

    AU - Glozier, Nicholas

    AU - Skinner, Timothy

    AU - Askew, Deborah A.

    AU - Gee, Graham

    AU - Cass, Alan

    AU - Brown, Alex

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    N2 - Objectives: To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander people. Design: Prospective observational validation study, 25 March 2015 – 2 November 2016. Setting, participants: 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions. Main outcome measures: Criterion validity of the aPHQ-9, with the depression module of the Mini-International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard. Results: 108 of 500 participants (22%; 95% CI, 18–25%) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ-9 algorithm for diagnosing a current major depressive episode was 54% (95% CI, 40–68%), its specificity was 91% (95% CI, 88–94%), with a positive predictive value of 64%. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95% CI, 0.85–0.92); with a cut-point of 10 points its sensitivity was 84% (95% CI, 74–91%) and its specificity 77% (95% CI, 71–83%). The aPHQ-9 was deemed acceptable by more than 80% of participants. Conclusions: Indigenous Australians found the aPHQ-9 acceptable as a screening tool for depression. Applying a cut-point of 10 points, the performance characteristics of the aPHQ were good.

    AB - Objectives: To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander people. Design: Prospective observational validation study, 25 March 2015 – 2 November 2016. Setting, participants: 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions. Main outcome measures: Criterion validity of the aPHQ-9, with the depression module of the Mini-International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard. Results: 108 of 500 participants (22%; 95% CI, 18–25%) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ-9 algorithm for diagnosing a current major depressive episode was 54% (95% CI, 40–68%), its specificity was 91% (95% CI, 88–94%), with a positive predictive value of 64%. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95% CI, 0.85–0.92); with a cut-point of 10 points its sensitivity was 84% (95% CI, 74–91%) and its specificity 77% (95% CI, 71–83%). The aPHQ-9 was deemed acceptable by more than 80% of participants. Conclusions: Indigenous Australians found the aPHQ-9 acceptable as a screening tool for depression. Applying a cut-point of 10 points, the performance characteristics of the aPHQ were good.

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