Indonesian patient health questionnaire's clinical utility in psychiatric outpatients: Ruling out conditions per ICD-11 criteria

Asian J Psychiatr. 2024 Oct:100:104184. doi: 10.1016/j.ajp.2024.104184. Epub 2024 Jul 27.

Abstract

This study aimed to assess the diagnostic accuracy of the Patient Health Questionnaire (PHQ) for identifying common mental disorders in an outpatient clinical psychologist office setting in Indonesia. A total of 661 outpatients from a clinical psychology office in Jakarta, Indonesia, participated in the study. The complete PHQ was administered, and its results were compared with diagnoses made by clinical psychologists based on ICD-11 criteria, including somatoform disorder (n = 6), depression (n = 117), Generalized Anxiety Disorder (GAD, n = 50), panic disorder (n = 42), bulimia nervosa (n = 2), binge eating disorder (n = 2), and other diagnoses such as OCD and BPD (n = 442). Receiver operating characteristics were computed to examine cut-off points, and optimal cut-off points based on the Youden Index were identified for somatoform disorder (PHQ-15 ≥ 13), depression (PHQ-9 ≥ 13), GAD (GAD- 7 ≥ 10), and panic disorder (PHQ-PD ≥ 7). Cut-off points for the alcohol abuse and eating disorder modules of the PHQ could not be determined due to a lack of sample, and AUC was suboptimal for PHQ-9, GAD-7, and PHQ-ED. The Indonesian PHQ demonstrated good sensitivity but low specificity in identifying somatoform disorder, depression, GAD, and panic disorders based on ICD-11 criteria among Indonesian clinical psychologist office outpatients. In the Indonesian outpatient psychiatric context, the utility of the Indonesian PHQ appeared to be most effective in ruling out diagnoses.

Keywords: Anxiety disorder; Bodily distress disorder; Major depressive disorder; Panic attack; ROC; Screening.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Indonesia
  • International Classification of Diseases*
  • Male
  • Mental Disorders / diagnosis
  • Middle Aged
  • Outpatients* / statistics & numerical data
  • Patient Health Questionnaire* / standards
  • Psychometrics / instrumentation
  • Psychometrics / standards
  • Sensitivity and Specificity
  • Young Adult