Accuracy of Self-Reported Items for the Screening of Depression in the General Population

Jorge Arias- de la Torre, Gemma Vilagut, Antoni Serrano-Blanco, Vicente Martín, Antonio José Molina, Jose M Valderas and Jordi Alonso
Additional contact information
Jorge Arias- de la Torre: Department of Psychological Medicine, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK
Gemma Vilagut: CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
Antoni Serrano-Blanco: CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
Vicente Martín: CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
Antonio José Molina: Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
Jose M Valderas: Health Services and Policy Research Group, University of Exeter Medical School, Exeter EX4 2LU, UK
Jordi Alonso: CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain

IJERPH, 2020, vol. 17, issue 21, 1-10

Abstract: Introduction: Though self-reported items (SRD, self-reported depression) are commonly used in health surveys and cohort studies, their metric properties as a depression indicator remain unclear. The aims were to evaluate the measurement properties of SRD using the Patient Health Questionnaire-8 (PHQ-8) as reference and to identify factors related to the agreement between both indicators. Methods: Data from the European Health Interview Survey in Spain in 2014/2015 (n = 22,065) were analyzed. Two indicators of depression were considered: SRD based on two items yes/no (positive: both yes), and the PHQ-8 (positive ≥ 10). Socioeconomic factors and use of health services were considered as independent variables. The prevalence of depression, sensitivity, specificity, global agreement, and positive and negative predictive values (PPV and NPV) of SRDs were evaluated using the PHQ-8 as a reference. Logistic regression models were fitted to determine factors associated with the agreement between indicators. Results: The prevalence of depression was lower when assessed with PHQ-8 (5.9%) than with SRD (7.7%). SRD sensitivity and PPV were moderate–low (52.9% and 40.4%, respectively) whereas global agreement, specificity, and NPV were high (92.7%, 95.1%, and 97.0%, respectively). Positive agreement was associated with marital status, country of birth, employment status, and social class. Negative agreement was related to all independent variables except country of birth. Conclusions: SRD items tend to overestimate the current prevalence of depression. While its use in health surveys and cohorts may be appropriate as a quick assessment of possible depression, due to their low sensitivity, its use in clinical contexts is questionable.

Keywords: depression; metric properties; sensitivity and specificity; health surveys (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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