Psychometric Properties of the Persian Versions of Patient Health Questionnaire-9 and Patient Health Questionnaire-2 in Patients with Coronary Heart Disease

Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-2 (PHQ-2) have been characterized as appropriate screening tools for coronary heart patients. However, their psychometric properties have not been assessed in Iranian coronary heart patients. This study aimed to determine the psychometric properties of the Persian versions of PHQ-9 and PHQ-2 in patients with Coronary Heart Disease (CHD). This cross-sectional study was conducted to investigate the psychometric properties of the Persian versions of PHQ-9 and PHQ-2 in patients with CHD. Totaly, 284 patients with CHD referred to Imam Ali Hospital in Kermanshah were selected through purposive sampling. They were first given a structured clinical interview (SCID-I) and were then asked to complete PHQ-9, PHQ-2, and Beck Depression Inventory-version 2 (BDI-II). The data were analyzed by descriptive statistics, Cronbach’s α, Spearman’s correlation coefficient, exploratory factor analysis, and Receiver Operating Characteristic (ROC) curve. Cronbach’s alpha was 0.86 for PHQ-9 and 0.77 for PHQ-2. The correlation between PHQ-9, and BDI-II and PHQ-2 was 0.74 and 0.80, respectively (P < 0.001). Additionally, the correlation between PHQ-2 and BDI-II was 0.64 (P < 0.001). Using exploratory factor analysis, a one-factor structure was extracted. The optimal cutoff point for PHQ-9 was ≥ 8 with the sensitivity of 0.80, specificity of 0.81, and Area Under the Curve (AUC) of 0.87 (95% confidence interval: 0.83 - 0.91). Additionally, the optimal cutoff point for PHQ-2 was ≥ 3 with the sensitivity of 0.68, specificity of 0.83, and AUC of 0.81 (95% confidence interval: 0.75 - 0.86). The Persian versions of PHQ-9 and PHQ-2 possessed acceptable psychometric properties and could, consequently, be used to screen depression in CHD patients.