Clin Psychopharmacol Neurosci.  2021 Feb;19(1):104-111. 10.9758/cpn.2021.19.1.104.

Standardization of the Korean Version of the Patient Health Questionnaire-4 (PHQ-4)

Affiliations
  • 1Department of Psychiatry, Gwangju Jeonnam Regional Military Manpower Administration, Gwangju, Korea
  • 2Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
  • 3Department of Psychiatry, Veterans Health Service Medical Center, Seoul, Korea

Abstract


Objective
The Patient Health Questionnaire-4 (PHQ-4) has been used for screening owing to ease of use and brevity. In this study, we developed the Korean version of the PHQ-4 and tested its validity.
Methods
One hundred sixteen new adult outpatients at the Department of Psychiatry of the Korea University Ansan Hospital participated in the study. We simultaneously administered other depression/anxiety scales: the Hamilton Rating Scale for Depression, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory.
Results
The mean PHQ-4 score was 6.52 (standard deviation = 3.45). Cronbach’s α was 0.792, and the intraclass correlation coefficient of test and 2-week interval retest was 0.827 (p < 0.01). The Pearson correlation coefficients between the PHQ-4 total score and other depression/anxiety scales were all over 0.6. Confirmatory factorial analysis showed acceptable convergent validity and reliability but questionable discriminant validity for some model fit values.
Conclusion
The Korean version of the PHQ-4 has sufficient internal consistency, test-retest reliability, and construct validity, but its two-factor structure showed incompleteness. However, we suggest that it should be used as a brief screening measure for common psychiatric distress that warrants further detailed assessment, but not to separately assess the severity of depression and anxiety symptoms.

Keyword

Patient Health Questionnaire-4; Standardization; Depression; Anxiety; Screening.
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