Article

OBJECTIVE: To evaluate whether items of the Patient Health Questionnaire 9
(PHQ-9) function differently in persons with traumatic brain injury (TBI) than in
persons from a primary care sample. DESIGN: This study was a retrospective
analysis of responses to the PHQ-9 collected in 2 previous studies. Responses to
the PHQ-9 were modeled using item response theory, and the presence of DIF was
evaluated using ordinal logistic regression. SETTING: Eight primary care sites
and a single trauma center in Washington state. PARTICIPANTS: Participants
(N=3365) were persons from 8 primary care sites (n=3000) and a consecutive sample
of persons with complicated mild to severe TBI from a trauma center who were 1
year postinjury (n=365). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE:
PHQ-9. RESULTS: No PHQ-9 item demonstrated statistically significant or
meaningful DIF attributable to TBI. A sensitivity analysis failed to show that
the cumulative effects of nonsignificant DIF resulted in a systematic inflation
of PHQ-9 total scores. Therefore, the results also do not support the hypothesis
that cumulative DIF for PHQ-9 items spuriously inflates the numbers of persons
with TBI screened as potentially having major depressive disorder. CONCLUSIONS:
The PHQ-9 is a valid screener of major depressive disorder in people with
complicated mild to severe TBI, and all symptoms can be counted toward the
diagnosis of major depressive disorder without special concern about
overdiagnosis or unnecessary treatment.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS