A comparison of PHQ-9 and TBI-QOL depression measures among individuals with traumatic brain injury.
Matthew L Cohen, James A Holdnack, Pamela A Kisala and 1 others
PMID 30024199WHAT IT FOUND
In 385 adults with TBI, the two depression screens agreed 82.9% to 84.7% at a common cutoff.
Disagreement came mainly from PHQ-9 body symptom items. TBI-QOL alone is not ready for clinical use.
Key findings
01In 385 adults with TBI, the TBI-QOL Depression scale and the PHQ-9 total score were strongly related, and the relation was stronger when the 4 somatic PHQ-9 items were excluded.
02At a TBI-QOL T-score of 60 or higher, the two depression screens agreed for 82.9% to 84.7% of participants.
03When the two screens disagreed, the difference was mainly on PHQ-9 items about sleep, fatigue, appetite, and psychomotor slowing, which raised PHQ-9 scores.
STILL TO COME
How it was doneWhat they found
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What it does not show
No clinical diagnosis of depression was available from a diagnostic interview, so the study compares screening labels rather than true depression. The TBI-QOL Depression cut-offs tested were not already validated for this population. Agreement between the measures changed depending on which cut-off scores were used. Many PHQ-9 positive screens may have been driven by body symptoms, which may or may not be due to depression. The number of people classified differently by the two tests was small, so those group differences may not generalize to a larger TBI population.
The easy way to misread this
Do not treat the TBI-QOL Depression score as a clinical diagnosis or a ready replacement for the PHQ-9. The study had no diagnostic interview, and the authors call it premature to use the TBI-QOL alone for clinical purposes.