PHQ-15

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The questionnaire PHQ-15

The PHQ-15 is a module of the Patient Health Questionnaire ( PHQ-D ) and is used to record the severity of somatic symptoms. The sum of the scales “somatic symptoms” comprises 15 somatic symptoms, which correspond to both the 15 most common physical complaints of outpatients and the most important DSM-IV criteria for somatization disorder. Since it has not proven to be relevant in the diagnosis of the somatoform disorder whether or not there is an organic cause for the somatic symptom, the criterion of the organic explainability of the body symptoms in the diagnosis of the somatoform disorders in DSM-5 is abandoned. Correspondingly, the point value of the PHQ-15, which does not require an organic explanation of the body symptoms, can also be used to measure the severity of the somatic symptoms as well as to measure the severity of the somatization.

The PHQ-15 is currently recommended by the DSM-5 working group of the American Psychiatric Association as a possible instrument for measuring the severity of the "Complex Somatic Symptom Disorder (CSSD)" according to the new DSM-5 criteria.

Structure of the PHQ-15

The PHQ-15 asks how severely you have felt impaired by various physical complaints over the past 4 weeks. Answer options are

  • "Not affected",
  • "Little affected" and
  • "Severely impaired",

to which the numerical values ​​0–2 are assigned accordingly. Two questions of the PHQ-15 come from the depression module of the PHQ-D ( PHQ-9 ). These are included as they ask about the important somatic symptoms of sleep disturbance and fatigue / lack of energy. The answer options are

  • "not at all",
  • "On individual days",
  • “On more than half the days” and
  • “Almost every day” to which the numbers 0–3 are assigned.

Evaluation of the PHQ-15

The sum of the scales “somatic symptoms” is formed from the 13 questions of the somatoform module (in the complete version of the ( PHQ-D ) these are questions 1a-1m) and questions 2c and 2d of the depression module ( PHQ-9 ). The 13 items of the somatoform module are included with

  • 0 ("Not Affected"),
  • 1 ("Slightly Impaired") or
  • 2 ("Severely Impaired")

rated.

The two questions from the depression section will correspond to the values

  • 0 ("Not at all"),
  • 1 ("On individual days") or
  • 2 ("More than half the days" or "Almost every day")

assigned. The scale sum value is between 0 and 30. The following table describes the interpretation of the possible scale sum values:

Calculated total scale value Symptom strength / somatization
0-4 Minimal somatic symptom strength / somatization
5-9 Mild somatic symptom strength / somatization
10-14 Moderately pronounced symptom strength / somatization
15-30 Severely pronounced symptom strength / somatization

Test diagnostic quality criteria of the PHQ-15

Criterion validity

In a study with 906 primary care patients, the PHQ-15 was found to have a sensitivity of 78% and a specificity of 71% for somatoform disorders according to DSM-IV.

Reliability

The internal reliability of the PHQ-15 is very good with a Cronbach α = .80.

Comparative values ​​for somatic symptom severity / somatization

In a study by Kroenke et al., Scale values ​​of the PHQ-15 were compared in a sample of patients with different anxiety disorders. The sample consisted of 777 patients without anxiety disorders, 73 with general anxiety disorders, 66 with panic disorder, 60 patients with social anxiety disorder and 83 patients with post-traumatic stress disorder. The scale value in patients without anxiety disorder was M = 6.0, in patients with generalized anxiety disorder M = 14.0, in patients with panic disorder and post-traumatic stress disorder M = 12 and in patients with social anxiety disorder M = 13.0

Within the German validation study by Graefe et al., Sum values ​​of the PHQ-15 in 357 general medical / internal medicine patients and 171 psychosomatic patients were examined in more detail. Patients with a mental disorder (according to SKID-I) had an average somatic symptom severity of 9.8 (SD = 5.4), patients without a mental disorder a value of 6.4 (SD = 3.9) and differed significantly from the group with a mental disorder (p < 0.001). The somatic symptom severity in the psychosomatic patient group was 9.7 (SD = 5.5) and in the medical patients 7.1 (SD = 4.4). These groups also differed significantly with regard to their symptom severity (p = <0.001).

Notes on usage authorization

The PHQ-D and its subscales are freely available and free of charge and can be used for non-commercial purposes without charge. When using the PHQ-D or a short form, the German version of the instrument must be quoted correctly when the data generated is published.

Web links

http://www.uke.de/kliniken/psychosomatik/

See also

Individual evidence

  1. ↑ a b c Kroenke K, Spitzer RL, Williams JB. The PHQ-15: Validity of a New Measure for Evaluating the Severity of Somatic Symptoms. Psychosom Med 2002; 64: 258-66.
  2. ↑ DSM-5 ( memento of October 19, 2012 in the Internet Archive ) on psychiatry.org
  3. ^ Van Ravesteijn H, Wittkampf K, Lucassen P, van de Lisdonk E, van den Hoogen H, van Weert H, Huijser J, Schene A, van Weel C, Speckens A. 2009. Detecting somatoform disorders in primary care with the PHQ- 15th Ann Fam Med. 7 (3): 232-8.
  4. ↑ Gräfe K, Zipfel S, Herzog W, Löwe B. Screening of mental disorders with the "Health Questionnaire for Patients (PHQ-D)". Results of the German validation study. Diagnostics; 2004; 50: 171-181.