Following one person over time

This measure exists to answer one question the 14 September briefing asked: does a person move from acute distress towards a clinical disorder, or away from it? It is for repeating with someone already in care, so the second score can be compared with the first.

Do not use this to screen a shelter. In the Nepali validation the cut-off of 10 or more had a positive predictive value of 0.42 — in that primary-care sample, fewer than half of the people who screened positive turned out to have a depressive episode. Run it across a displaced population and most positives will be wrong, while the people you flag will have been told something about themselves that is not true. Use it where someone has already been identified and referred.

The Nepali text is missing, and this form is not ready for field use without it. The Nepali version validated by the PRIME consortium exists, but the copy available is typeset in a legacy non-Unicode Nepali font, so the characters cannot be transferred here without risking a corrupted questionnaire. Nothing has been translated or approximated. Before any real use, obtain the Unicode Nepali items from the PRIME / Kohrt source and have them checked by a Nepali-speaking clinician. Administering the English items to a Nepali speaker through an untrained interpreter is not the same instrument and the cut-off does not carry over.

Who, and which visit

Organisation

Administered by

A measure like this belongs with a counsellor or clinician, not a volunteer.

Date — Gregorian (AD)

Contact code

Paste the code from the person's service contact record, so the two scores can be lined up without a name.

Which administration is this?

Language used

Recorded because it changes what the score means.

Consent

The person was told what this is for and agreed to answer

The nine items

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Difficulty, and the score

If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

— out of 27 answer all nine items

Bands are the standard PHQ-9 cut-points (Kroenke, Spitzer & Williams, 2001): 0–4 minimal, 5–9 mild, 10–14 moderate, 15–19 moderately severe, 20–27 severe. The action threshold of 10 or more is the one validated in Nepal (Kohrt et al., 2016; sensitivity 0.94, specificity 0.80, in 125 primary-care patients in Chitwan). A score is not a diagnosis and must not be recorded as one.

Save

Item-by-item answers are kept because a total alone cannot be re-checked, and because item 9 has to be auditable. There is no name, no phone number and no date of birth.

Attribution

PHQ-9 was developed by Drs Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. The instrument carries the statement: “No permission required to reproduce, translate, display or distribute.” The items above are reproduced verbatim on that basis. The Nepali adaptation was made and validated through the Programme for Improving Mental Health Care (PRIME) consortium, funded by UK aid — and is not included here, for the reason given at the top of this page.