Validation of the WHO-5 as a first-step screening instrument for depression in adults with diabetes

Results from Diabetes MILES - Australia

Jennifer A. Halliday*, Christel Hendrieckx, Lucy Busija, Jessica L. Browne, G.M. Nefs, Francois Pouwer, Jane Speight

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aims: 

Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes.

Methods: 

The Diabetes MILES -Australia study dataset provided a sample of N = 3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full sample, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (

Results: 

For the whole sample, the WHO-5 demonstrated satisfactory internal consistency reliability (a = 0.90) and convergent validity with the PHQ-9 (r = -0.73, p <0.001). Confirmatory factor analysis partially supported factorial validity:.2(5) = 834.94, p <0.001; RMSEA = 0.23, 90% CI 0.21-0.24; CFI = 0.98, TLI = 0.96; factor loadings = 0.78-0.92. The AUC was 0.87 (95% CI: 0.86-0.89, p <0.001). The sensitivity/specificity of the WHO-5 for detecting likely depression was 0.44/ 0.96 for the

Conclusions: 

These findings support use of a WHO-5 cut-point of

Original languageEnglish
Pages (from-to)27-35
JournalDiabetes Research and Clinical Practice
Volume132
DOIs
Publication statusPublished - 2017

Keywords

  • Diabetes mellitus
  • Depression
  • Surveys and questionnaires
  • Psychometrics
  • Factor analysis
  • statistical
  • ROC curve
  • WELL-BEING-INDEX
  • PRIMARY-CARE
  • OUTPATIENTS
  • PEOPLE
  • ASSOCIATION
  • DISTRESS
  • VALIDITY
  • QUALITY
  • TOOLS
  • PHQ-9

Cite this

Halliday, Jennifer A. ; Hendrieckx, Christel ; Busija, Lucy ; Browne, Jessica L. ; Nefs, G.M. ; Pouwer, Francois ; Speight, Jane. / Validation of the WHO-5 as a first-step screening instrument for depression in adults with diabetes : Results from Diabetes MILES - Australia. In: Diabetes Research and Clinical Practice. 2017 ; Vol. 132. pp. 27-35.
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title = "Validation of the WHO-5 as a first-step screening instrument for depression in adults with diabetes: Results from Diabetes MILES - Australia",
abstract = "Aims: Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes.Methods: The Diabetes MILES -Australia study dataset provided a sample of N = 3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full sample, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (Results: For the whole sample, the WHO-5 demonstrated satisfactory internal consistency reliability (a = 0.90) and convergent validity with the PHQ-9 (r = -0.73, p <0.001). Confirmatory factor analysis partially supported factorial validity:.2(5) = 834.94, p <0.001; RMSEA = 0.23, 90{\%} CI 0.21-0.24; CFI = 0.98, TLI = 0.96; factor loadings = 0.78-0.92. The AUC was 0.87 (95{\%} CI: 0.86-0.89, p <0.001). The sensitivity/specificity of the WHO-5 for detecting likely depression was 0.44/ 0.96 for theConclusions: These findings support use of a WHO-5 cut-point of",
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author = "Halliday, {Jennifer A.} and Christel Hendrieckx and Lucy Busija and Browne, {Jessica L.} and G.M. Nefs and Francois Pouwer and Jane Speight",
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Validation of the WHO-5 as a first-step screening instrument for depression in adults with diabetes : Results from Diabetes MILES - Australia. / Halliday, Jennifer A.; Hendrieckx, Christel; Busija, Lucy; Browne, Jessica L.; Nefs, G.M.; Pouwer, Francois; Speight, Jane.

In: Diabetes Research and Clinical Practice, Vol. 132, 2017, p. 27-35.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Validation of the WHO-5 as a first-step screening instrument for depression in adults with diabetes

T2 - Results from Diabetes MILES - Australia

AU - Halliday, Jennifer A.

AU - Hendrieckx, Christel

AU - Busija, Lucy

AU - Browne, Jessica L.

AU - Nefs, G.M.

AU - Pouwer, Francois

AU - Speight, Jane

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N2 - Aims: Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes.Methods: The Diabetes MILES -Australia study dataset provided a sample of N = 3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full sample, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (Results: For the whole sample, the WHO-5 demonstrated satisfactory internal consistency reliability (a = 0.90) and convergent validity with the PHQ-9 (r = -0.73, p <0.001). Confirmatory factor analysis partially supported factorial validity:.2(5) = 834.94, p <0.001; RMSEA = 0.23, 90% CI 0.21-0.24; CFI = 0.98, TLI = 0.96; factor loadings = 0.78-0.92. The AUC was 0.87 (95% CI: 0.86-0.89, p <0.001). The sensitivity/specificity of the WHO-5 for detecting likely depression was 0.44/ 0.96 for theConclusions: These findings support use of a WHO-5 cut-point of

AB - Aims: Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes.Methods: The Diabetes MILES -Australia study dataset provided a sample of N = 3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full sample, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (Results: For the whole sample, the WHO-5 demonstrated satisfactory internal consistency reliability (a = 0.90) and convergent validity with the PHQ-9 (r = -0.73, p <0.001). Confirmatory factor analysis partially supported factorial validity:.2(5) = 834.94, p <0.001; RMSEA = 0.23, 90% CI 0.21-0.24; CFI = 0.98, TLI = 0.96; factor loadings = 0.78-0.92. The AUC was 0.87 (95% CI: 0.86-0.89, p <0.001). The sensitivity/specificity of the WHO-5 for detecting likely depression was 0.44/ 0.96 for theConclusions: These findings support use of a WHO-5 cut-point of

KW - Diabetes mellitus

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KW - Factor analysis

KW - statistical

KW - ROC curve

KW - WELL-BEING-INDEX

KW - PRIMARY-CARE

KW - OUTPATIENTS

KW - PEOPLE

KW - ASSOCIATION

KW - DISTRESS

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SN - 0168-8227

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