The patient health questionnaire for adolescents: Validation of an instrument for the assessment of mental disorders among adolescent primary care patients

Johnson, Jeffrey G; Harris, Emily S; Spitzer, Robert L; Williams, Janet B.W

« Previous Next »Journal of Adolescent Health
Volume 30, Issue 3 , Pages 196-204, March 2002

The patient health questionnaire for adolescents:

Validation of an instrument for the assessment of mental disorders among adolescent primary care patients

Jeffrey G Johnson, Ph.D.
- Address correspondence to: Jeffrey G. Johnson, Ph.D., Box 60, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032 USA
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York, USA (J.G.J., R.L.S., J.B.W.W.)
Emily S Harris, M.D.
- Department of Psychiatry and the Center for Health Services Research in Primary Care, University of California, Davis, California, USA (E.S.H.)
Robert L Spitzer, M.D.
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York, USA (J.G.J., R.L.S., J.B.W.W.)
Janet B.W Williams, D.S.W.
- Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, New York, USA (J.G.J., R.L.S., J.B.W.W.)

Accepted 13 August 2001.

Abstract

Purpose: To investigate the validity of the Patient Health Questionnaire for Adolescents (PHQ-A), a self-administered instrument that assesses anxiety, eating, mood, and substance use disorders among adolescent primary care patients.

Methods: A total of 403 adolescents from California, New Jersey, New York, and Ohio completed the PHQ-A and the Medical Outcomes Study Short-Form General Health Survey (SF-20) during or shortly after a visit to a primary care clinic or a school nurse’s office. A few days later, clinical psychologists who were blind to the results of the PHQ-A administered a semi-structured clinical interview to assess the same psychiatric disorders and to conduct a global assessment of functioning (GAF) among 403 patients. Diagnostic agreement coefficients were computed and analyses of covariance were conducted.

Results: Findings support the diagnostic validity of the PHQ-A. The PHQ-A and the clinical interview produced similar estimates of the prevalence rates of anxiety, eating, mood, and substance use disorders. The PHQ-A demonstrated satisfactory sensitivity, specificity, diagnostic agreement, and overall diagnostic accuracy, compared with the clinical interview. Adolescents with PHQ-A diagnoses experienced significantly poorer mental and overall functioning, more physical pain, and poorer overall health compared with those without psychiatric disorders. These differences remained significant after patients’ age, gender, ethnicity, and site were controlled statistically.

Conclusion: The PHQ-A may be used to assist primary care practitioners in identifying psychiatric disorders among their adolescent patients. The PHQ-A is the first such tool to be tested for use in adolescents and offers an acceptable and efficient tool for early detection and recognition of mental disorders in this high-risk group.