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Agreement among brief patient health questionnaire (PHQ) versions for measuring symptoms of depression in the Brazilian national health survey (PNS).

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Τίτλος: Agreement among brief patient health questionnaire (PHQ) versions for measuring symptoms of depression in the Brazilian national health survey (PNS).
Συγγραφείς: de Oliveira LRF; Post-Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto, Minas Gerais, Brazil., Barbosa BCR; Post-Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto, Minas Gerais, Brazil.; Ministry of Health, Brasilia, Federal District, Brazil., Vidigal MCA; Post-Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto, Minas Gerais, Brazil., Meireles AL; Post-Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto, Minas Gerais, Brazil., Menezes-Júnior L; Post-Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto, Minas Gerais, Brazil. luiz.menezes@ufop.edu.br.; Ministry of Health, Brasilia, Federal District, Brazil. luiz.menezes@ufop.edu.br.
Πηγή: Scientific reports [Sci Rep] 2026 May 04; Vol. 16 (1). Date of Electronic Publication: 2026 May 04.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
Imprint Name(s): Original Publication: London : Nature Publishing Group, copyright 2011-
Ιατρικοί όροι (MeSH): Depression*/diagnosis , Depression*/epidemiology , Patient Health Questionnaire* , Health Surveys*, Brazil/epidemiology ; Mass Screening/methods ; Humans ; Female ; Adult ; Middle Aged ; Male ; Cross-Sectional Studies ; Adolescent ; Young Adult ; ROC Curve ; Aged
Περίληψη: To evaluate the agreement of the 2-item (PHQ-2) and 8-item (PHQ-8) Patient Health Questionnaires compared to the PHQ-9 and clinical diagnosis for depression screening in Brazilian adults, and to examine associated sociodemographic and behavioral factors. We analyzed cross-sectional data from 148,733 participants in the 2013 and 2019 Brazilian National Health Surveys. ROC curve analyses identified optimal cutoffs for PHQ-8 and PHQ-2 against the PHQ-9 (≥ 10) and clinical indicators. Logistic regression and Ratio of Odds Ratios (ROR) compared associations across screening tools and self-reported diagnosis. The PHQ-8 (cutoff ≥ 10) showed near-perfect agreement with the PHQ-9 (AUC = 0.982). For the PHQ-2, a ≥ 3 cutoff optimized specificity (96.4%) and overall agreement (94.7%), with an AUC of 0.877. Optimal cutoffs against clinical indicators shifted lower (≥ 4 for PHQ-8; ≥ 1 for PHQ-2). Both brief versions identified associations profiles consistent with the PHQ-9 (e.g., higher odds in women, low-income individuals, and those with chronic diseases). However, ROR analyses revealed a significant healthcare gap: higher income and advancing age strongly predicted formal diagnosis, while Black/Brown populations and those with poor health were significantly underrepresented clinically compared to symptom screening. All scales showed strong reliability (α, ω > 0.85), including the PHQ-2 (r = 0.55; ρsb = 0.71). The PHQ-8 is a psychometrically equivalent alternative to the PHQ-9 in Brazil, and the PHQ-2 is a reliable, ultra-brief tool ideal for rapid, large-scale population screening. While these scales accurately capture symptom burden, the observed discrepancies with formal diagnosis highlight significant systemic barriers to mental healthcare access for vulnerable subgroups.
(© 2026. The Author(s).)
Competing Interests: Declarations. Competing interests: The authors declare that they have no competing interests. Consent for publication: Informed consent was obtained from all individual participants included in the study. Human and animal participants: The Brazilian National Health Survey (PNS) was approved by the National Commission for Ethics in Research (CONEP) (Report No. 10853812.7.0000.0008) in June 2013, in compliance with Resolution No. 466/2012 of the National Health Council (CNS). All participants provided informed consent. Participation was voluntary, with guarantees of anonymity and the right to withdraw at any time.
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Contributed Indexing: Keywords: Health surveys; Patient health questionnaire; Psychological tests; Public health; Validation study
Entry Date(s): Date Created: 20260504 Date Completed: 20260702 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13328707
DOI: 10.1038/s41598-026-51712-7
PMID: 42082720
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2045-2322
DOI:10.1038/s41598-026-51712-7