Abstract
BackgroundThis study aimed to investigate the reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-15) in a tertiary hospital.MethodsUsing a cross-sectional study design, the Chinese version of the PHQ-15 was administered to a total of 1329 inpatients. To examine the discriminant validity of this questionnaire, we investigated the correlation of the PHQ-15 score with sociodemographic data and the PHQ-9 and GAD-7 scale scores. Exploratory factor analysis was performed to assess the internal consistency of the PHQ-15. To evaluate the consistency of this questionnaire with item response theory (IRT), IRT analysis was performed.ResultsThe Chinese version of the PHQ-15 showed good reliability (Cronbach’s alpha = 0.83). The correlations of the PHQ-15 scores with the PHQ-9 depression scale scores (r = 0.565) and the GAD-7 anxiety scale scores (r = 0.512) were moderate; these results suggested that the PHQ-15 had discriminant validity. We identified three factors, referred to as “cardiopulmonary,” “gastrointestinal,” and “pain/neurological,” which explained 56 % of the total variance. A second-order factor analysis including these three factors produced an acceptable model. Several items (4, 8 and 11) displayed extreme floor effects. Additionally, item 4 displayed a very small variance of 0.35 and showed very small differences in its thresholds based on IRT analysis.ConclusionsThe PHQ-15 scale had good reliability and high validity to detect patients with high somatic symptom severity in a Chinese tertiary hospital. Several of the current findings were consistent with previous research on the PHQ-15 in Western countries and in China. To improve the diagnostic quality of this questionnaire, items 4, 8 and 11 can be omitted.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0798-5) contains supplementary material, which is available to authorized users.
Highlights
This study aimed to investigate the reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-15) in a tertiary hospital
Description of the sample Of the 1662 inpatients approached in the 10 departments, 151 patients were excluded based on the exclusion criteria, and 149 patients refused to participate in the study
The present study evaluated the Chinese version of the PHQ-15 in a large tertiary hospital inpatient setting in Chengdu
Summary
This study aimed to investigate the reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-15) in a tertiary hospital. Patients with multiple distressing somatic symptoms are prevalent in primary, secondary and tertiary care settings [1,2,3,4]. The Patient Health Questionnaire (PHQ)-15 [5] is an economical, self-administered instrument that has been used as a screening tool in several studies. Among 40 self-reported somatic symptom scales investigated in a review, the PHQ-15 and the 12-item Symptom Checklist–90 somatization scale [13] were identified as the most appropriate measures for large-scale studies because of their well-established psychometric properties, relevance to symptoms, brevity, and availability in multiple languages [11]
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