Mood Emot 2014 Feb; 12(1): 32-36  
Finding Optimal Cut Off Points of the Korean Version of the Patient Health Questionnaire-9(PHQ-9) for Screening Depressive Disorders
Seunghyun Lee, MA1, Yujeong Huh, MA1, Jonghun Kim, MD2 and Changsu Han, MD, PhD, MHS2
1Department of Psychiatry, Korea University Ansan Hospital, Office for Clinical Psychology, Ansan, Korea
2Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
Correspondence to: 한창수, 425-707 경기도 안산시 단원구 적금로 123 고려대학교 의과대학 정신건강의학교실 전화 : (031) 412-5140·전송 : (031) 412-5144 E-mail : hancs@korea.ac.kr
Received: October 8, 2013; Revised: October 8, 2013; Accepted: February 17, 2014; Published online: February 28, 2014.
© Korean Society for Affective Disorders. All rights reserved.

Abstract
Objectives : Depressive disorder is one of mental disorders associated with suicide. PHQ-9 is widely used screening instrument for depression in clinical settings. However, there is considerable divergence of opinion about cutoff points of the PHQ-9. The aim of this study was to find the valid, optimal cutoff points to screen depressive disorders using the Korean version of PHQ-9.M
Methods : 139 psychiatric patients who were diagnosed as MDD, dysthymic disorder, depressive disorder not otherwise specified, and other non-psychotic psychiatric disorders with the M.I.N.I. PLUS were recruited. Subsequently, the PHQ-9, HDRS, PHQ-15, MMPI-Depression scale were administered. Reliability, validity and the ROC curve analysis were performed.
Results : The internal reliability using Cronbach’s alpha was relatively high (Cronbach’s alpha=0.85). In addition, correlations of the PHQ-9 with the HDRS, PHQ-15 and MMPI-Depression scale were 0.691, 0.582, and 0.404_ (p＜.01). Between the depression and non-depression groups, the AUC_ (area under the ROC curve) was 0.712_ (standard error=0.051, p＜.001) and the PHQ-9 had a cut-off point of 6_ (sensitivity 91.5%, specificity 33.3%). Between MDD and non-MDD groups, the AUC was 0.827 (standard error=0.035, p＜.001) and the PHQ-9 had a cut-off point of 10_ (sensitivity 86.5%, specificity 52.9%).
Conclusion : The PHQ-9 is considered as a short and valid tool to identify MDD (PHQ-9 total score 10).
Keywords: Major depressive disorder ㆍDepression ㆍPatient Health Questionnaire-9 ㆍCut-off point.

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