Patient Health Questionnaire (PHQ)- Nepal

Information about Measure
First Name Brandon
Last Name Kohrt
Email Not Available
Affiliation Duke Global Health Institute, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, USA
Other means of contacting author (e.g., website,, ResearchGate)
Mental health assessment tool that was adapted/developed/validated Patient Health Questionnaire 9, PHQ9 Nepal Version
Mental health condition assessed Depressive Disorders
Idiom of distress included, if any manko samasya or “heart-mind” problems
Lifestage of interest Adult (General)
Age range (age – age)
Country or countries where tool was developed/adapted/validated Nepal
Language(s) of the adapted/developed/validated tool Nepali
Clinical or community sample? Community
Subpopulation in which tool was developed/validated (e.g., tool was developed and tested among middle-class women)? 125 male and female adults drawn from a random sample of community clinics in Nepal.
Development procedures culturally-adapted,validated,locally-developed
If validated, what was the gold standard? Composite International Diagnostic Interview (CIDI) Nepal version
Description of other development procedures, if applicable
Cronbach’s alpha 0.84
Sensitivity 0.94
Spec 0.8
Other information about tool (e.g., additional psychometrics [NPV, PPV, Youden’s index, diagnostic odds ratio]) The PHQ9 was translated and reviewed by community focus groups drawn from diverse age, caste, and literacy levels. After revision for concept and semantic validity, items assessing the local idiom of distress ‘heart-mind’ problems were added. It was administered as an interview to a community sample of adult men and women along with the clinician adminstered CIDI.

Senstivity and specificity are reported for a PHQ9 cutoff score of 10 and above. PPV was 0.42 (95 % CI 0.27—0.59), and NPV was 0.99 (95 % CI 0.93—1.00), with a positive likelihood ratio of 4.62 (95 % CI 3.12—6.83), and negative likelihood ratio of 0.07 (95 % CI 0.01—0.47). Heart-mind problems had a sensitivity of 0.94 (95 % CI 0.69—1.00), specificity of 0.27 (95 % CI 0.19—0.36), PPV of 0.17 (95 % CI 0.10—0.26), and NPV of 0.97 (95 % CI 0.81—1.00). Brain-mind problems had low sensitivity for CIDI positive status (sensitivity = 0.47, 95 % CI 0.25—0.71).

Citations of development/adaptation/validation studies and/or previous studies using the tool Kohrt, B. A., Luitel, N. P., Acharya, P., & Jordans, M. J. (2016). Detection of depression in low resource settings: validation of the Patient Health Questionnaire (PHQ-9) and cultural concepts of distress in Nepal. BMC psychiatry, 16(1), 58.
Notes when administering the tool The PHQ9 Nepal version should be administered by a healthcare worker as an interview. Visual response aids may be helpful. The total score is used with all items equally weighted.