Sample Measure Critique of PHQ9

Northcentral University                                                                                  MSW-6007


Don't use plagiarized sources. Get Your Custom Essay on
Sample Measure Critique of PHQ9
Just from $9/Page
Order Essay

Sample Measure Critique



Critiqued by: KL


Date: January 25, 2016


Name of measure: PHQ9


Developer(s): Kurt Kroenke, Robert L. Spitzer, & Janet B.W. Williams


Source reference:


Construct(s) assessed: Criteria-based diagnosis of depression in individuals seen in primary care and other medical and mental health facilities


Method of administration: Nine symptom checklist that can be professionally or self-administered (paper and pencil, electronically, or over the phone).


Summary of reliability evidence:

  • Internal reliability was excellent, with a Cronbach’s alpha of 0.89 in a Primary Care Study and 0.86 in an OB-Gyn Study (Kroenke, Spitzer, & Williams, 2001).
  • Test-retest reliability was very high at a 0.96 in a longitudinal study (Draper et al., 2008).


Summary of validity evidence:

In a study done by Kroenke et al. (2001), both criterion and construct validity were established as well as external validity. Construct validity was demonstrated in a sample of 580 primary care patients who underwent an independent re-interview. Criterion validity was shown by the strong association between PHQ-9 scores and functional status disability days and symptoms related difficulty. External validity was achieved by replicating the findings from 3,000 primary care patients in a second sample of 3,000 Ob-gyn patients.

  • The PHQ-9 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 sores of 5, 10, 15, 20 fully represented mild, moderate, moderately severe, and severe depression respectively (Kroenke et al., 2001).


Summary of clinical use:

The PHQ-9 was founded and used in primary care settings where a nurse, physician or mental health provider has administered the questionnaire. In recent years, it has also been administered in many different types of medical settings and in mental health offices. Administration by telephone and touch-screen has been validated (Fann et al., 2009; Kroenke et al., 2001). Often times it is self administered and the mental health provider or medical health provider can score and determine possible depression and severity at the time administered. It has also been shown to notify mental health providers if therapy/treatment is going well.


Recommendations for clinical use:

The PHQ-9 is a tool that can be used for diagnosing depression, depression severity, and gauging response to depression treatment in clinical research (Lowe, Unutzer, Callahan & Kroenke, 2004; Lowe, Unutzer, Callahan, Perkins, & Kroenke, 2004). The PHQ-9 will be of great help in therapy to determine if the patient is responding to therapy/treatment. This particular measure is designed to be used in conjunction with the DSM-5 to provide correct diagnosis and severity level. Since this assessment tool has been used widely throughout different settings and with a diverse population, it will be important to research your population/setting to best reach a correct diagnosis and severity level, especially during therapy.


Summary of research use:

  • Clinical Interviewing for depression (Fann et al., 2005)
  • Determining depression in primary care settings (DeJesus, Vickers, Melin, Williams, 2007; Kroenke et al., 2001)
  • Comparisons to other mental health assessments (Draper et al., 2008; Kroenke et al., 2001)
  • Determining if the assessment works for other cultures and countries (Huang, Chung, Kroenke, Delucchi & Spitzer, 2006; Yeung et al., 2008 )
  • Longitudinal research of depression after traumatic events (Draper et al., 2008)
  • Diagnosis and assessment of depression with comorbid disease or medical conditions (Lamers et al., 2008; Fann et al., 2005)
  • Ability to predict depression severity and accomplishment of therapy/treatments (Lowe, Unutzer, Callahan, et al., 2004a; Lowe, Unutzer, Callahan, Perkins, et al., 2004b).


Populations utilized with:

The population has been utilized and validated with individuals of various cultural backgrounds, countries, languages, medical conditions, marital status, gender, age, regions of the U.S., post-disaster, education status, and economical status. Some examples to name a few are as follows:

  • Oncology, using touch screens (Fann et al., 2009)
  • Individuals following traumatic brain injury (Fann et al., 2005)
  • Primary care patients (DeJesus et al., 2007)
  • Those affected by child abuse or gender-based violence (Anastario, Larrance & Lawry, 2008; Draper et al., 2008)
  • Used in different countries and in different language versions (Han et al., 2008; Yeung et al., 2008)
  • Racially and ethnically diverse population at primary care facilities (African American, Chinese American, Latino, and non-Hispanic white patient groups) (Huang et al., 2006)
  • Chronically ill elder patients (Lamers et al., 2008)


Example of use in research: (Lamers et al., 2008)

Objective: to assess the psychometric properties of the PHQ-9 as a screening tool for depression in elderly patients with diabetes and chronic obstructive pulmonary disease (COPD) without previously known depression.


Method/Design: Diabetes and COPD patients older than 59 years were given PHQ-9. 105 participants were given a test-retest assessment. Participants were also given the Mini International Neuropsychiatric Interview psychiatric interview to diagnose major depressive disorder (MDD) and established Criterion validity. Correlations with quality of life and severity of illness were calculated to assess construct validity.


Results: PHQ-9 is a valid and reliable screening instrument for depression in elderly primary care patients with diabetes and COPD


Future research needed:

Future research is needed to determine if the PHQ-9 would be used instead of longer, more costly, interviewer-administered outcome measures such as the Hamilton Depression Rating Scale.


Overall impression of measure:

The PHQ-9 has well established reliability and validity and can be used with a variety of populations in both medical and non-medical settings. I think it can be a wonderful tool for clinicians with depressed clients to determine if therapy is working.




Anastario, M. P., Larrance, R., & Lawry, L. (2008). Using Mental Health Indicators to Identify   Postdisaster Gender-Based Violence among Women Displaced by Hurricane Katrina.    Journal of Women’s Health, 17(9), 1437-1444.


DeJesus, R. S., Vickers, K. S., Melin, G. J., & Williams, M. D. (2007). A System-Based                Approach to Depression Management in Primary Care Using the Patient Health Questionnaire-9. Mayo Clinic Proceedings, 82(11), 1395-1402.


Draper, B., Pfaff, J. J., Pirkis, J., Snowdon, J., Lautenschlager, N. T., Wilson, I., et al. (2008).       Long-Term Effects of Childhood Abuse on the Quality of Life and Health of Older     People: Results from the Depression and Early Prevention of Suicide in General Practice       Project. Journal of the American Geriatrics Society, 56(2), 262-271.


Fann, J. R., Berry, D. L., Wolpin, S., Austin-Seymour, M., Bush, N., Halpenny, B., et al. (2009). Depression screening using the Patient Health Questionnaire-9 administered on a touch            screen computer. Psycho-Oncology, 18(1), 14-22.


Fann, J. R., Bombardier, C. H., Dikmen, S., Esselman, P., Warms, C. A., Pelzer, E., et al. (2005). Validity of the Patient Health Questionnaire-9 in Assessing Depression Following        Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 20(6), 501-511.


Han, C., Jo, S. A., Kwak, J. H., Pae, C. U., Steffens, D., Jo, I., et al. (2008). Validation of the                  Patient Health Questionnaire-9 Korean version in the elderly population: the Ansan           Geriatric study. Comprehensive Psychiatry, 49(2), 218-223.


Huang, F., Chung, H., Kroenke, K., Delucchi, K., & Spitzer, R. L. (2006). Using the Patient         Health Questionnaire-9 to Measure Depression among Racially and Ethnically Diverse      Primary Care Patients. Journal of General Internal Medicine, 21(6), 547-552.


Huang, F. Y., Chung, H., Kroenke, K., Delucchi, K. L., & Spitzer, R. L. (2006). Using the           Patient Health Questionnaire-9 to measure depression among racially and ethnically           diverse primary care patients. Journal of General Internal Medicine, 21(6), 547-552.


Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. JGIM: Journal of General Internal Medicine, 16(9), 606-613.


Laowe, B., Kroenke, K., Herzog, W., & Grafe, K. (2004). Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire            (PHQ-9). Journal of Affective Disorders, 81(1), 61-66.


Laowe, B., Unutzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004). Monitoring            depression treatment outcomes with the patient health questionnaire-9. Medical Care, 42(12), 1194-1201.


Lamers, F., Jonkers, C. C., Bosma, H., Penninx, B. W., Knottnerus, J. A., & van Eijk, J. T.            (2008). Summed score of the Patient Health Questionnaire-9 was a reliable and valid         method for depression screening in chronically ill elderly patients. Journal Of Clinical        Epidemiology, 61(7), 679-687.


Yeung, A., Fung, F., Yu, S. C., Vorono, S., Ly, M., Wu, S., et al. (2008). Validation of the           Patient Health Questionnaire-9 for depression screening among Chinese Americans.           Comprehensive Psychiatry, 49(2), 211-217.



Get Professional Assignment Help Cheaply

Buy Custom Essay

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Why Choose Our Academic Writing Service?

  • Plagiarism free papers
  • Timely delivery
  • Any deadline
  • Skilled, Experienced Native English Writers
  • Subject-relevant academic writer
  • Adherence to paper instructions
  • Ability to tackle bulk assignments
  • Reasonable prices
  • 24/7 Customer Support
  • Get superb grades consistently

Online Academic Help With Different Subjects


Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.


Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.

Computer science

Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!


While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.


Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.


In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.


Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.


We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!


We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.


Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.

What discipline/subjects do you deal in?

We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.

Are your writers competent enough to handle my paper?

Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.

What if I don’t like the paper?

There is a very low likelihood that you won’t like the paper.

Reasons being:

  • When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
  • We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.

In the event that you don’t like your paper:

  • The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
  • We will have a different writer write the paper from scratch.
  • Last resort, if the above does not work, we will refund your money.

Will the professor find out I didn’t write the paper myself?

Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.

What if the paper is plagiarized?

We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.

When will I get my paper?

You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.

Will anyone find out that I used your services?

We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.

How our Assignment Help Service Works

1. Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2. Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3. Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4. Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.

smile and order essay GET A PERFECT SCORE!!! smile and order essay Buy Custom Essay

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
The price is based on these factors:
Academic level
Number of pages
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more
error: Content is protected !!
Open chat
Need assignment help? You can contact our live agent via WhatsApp using +1 718 717 2861

Feel free to ask questions, clarifications, or discounts available when placing an order.
  +1 718 717 2861           + 44 161 818 7126           [email protected]
  +1 718 717 2861         [email protected]