<p>I am sharing my research here should anybody find it useful.</p>

<p>=========================================================================</p>

<p>Although PHQ-9 wasn’t developed for an Indian audience, it has been used by multiple
studies in India [1, 2, 3]. It has also been validated for an adolescent population, and a
score of was found to have high sensitivity (87.1%) and specificity (79.7%) [4]. A
modified version of PHQ-9, the PHQ-12, was developed and validated on a South Indian
population of 100 participants. PHQ-12 essentially tests the same symptoms as PHQ-9
but differs in number of questions, the specific wordings of the questions, and the
marking scheme. PHQ-12 lets the patient mark every question in a ‘Yes’ or ‘No’. A
‘Yes’ is given a score of 1 and a ‘No’ a score of 0. A total score of &gt;4 according to this</p>

<p>marking scheme has shown the highest sensitivity (92.0%) and specificity (90.7%) when
compared against PHQ-9 [5].
Other popular scales for diagnosis of depression - Hamilton Depression Rating Scale,
Beck Depression Inventory, and Montogomery Asberg Depression Rating Scale - have
been adapted for an Indian population [6, 7, 8]. Brief Patient Health Questionnaire has
also been translated into 11 Indian languages and validated for an Indian population [9].
A novel scale, Amritsar Depressive Inventory (ADI), has been developed based on
symptoms which are more prevalent in Indian populations [10].</p>

<ol>
<li>Mehrotra, Seema, et al. &quot;Profile of seekers of an internet-based self-help program
for depression in India: observations and implications.&quot; International Journal Of
Community Medicine And Public Health (2017).</li>
<li>Sidana, Surbhi, et al. &quot;Prevalence of depression in students of a medical college in
New Delhi: a cross-sectional study.&quot; The Australasian medical journal 5.5
(2012): 247.</li>
<li>Thour, Amit, et al. &quot;Depression among patients with diabetes mellitus in North
India evaluated using patient health questionnaire-9.&quot; Indian journal of
endocrinology and metabolism 19.2 (2015): 252.</li>
<li>Ganguly, Samrat, et al. &quot;Patient health questionnaire-9 as an effective tool for
screening of depression among Indian adolescents.&quot; Journal of Adolescent Health
52.5 (2013): 546-551.</li>
<li>Poongothai, S., et al. &quot;Reliability and validity of a modified PHQ-9 item
inventory (PHQ-12) as a screening instrument for assessing depression in Asian
Indians (CURES-65).&quot; (2009).</li>
<li>Ajmany S, Nandi DN. Adaptation of A. T. Beck et al.&#39;s &quot;an inventory for
measuring depression&quot; Indian J Psychiatry 1973;15:386-90.</li>
<li>Ganguli M, Dube S, Johnston JM, Pandav R, Chandra V, Dodge HH. Depressive
symptoms, cognitive impairment and functional impairment in a rural elderly
population in India: A Hindi version of the geriatric depression scale (GDS-H).
Int J Geriatr Psychiatry 1999;14:807-20.</li>
<li>Raguram R, Weiss MG, Channabasavanna SM, Devms GM. Stigma, depression,
and somatization in south India. Am J Psychiatry 1996;1531043-9.</li>
<li>Kochhar, P. H., S. S. Rajadhyaksha, and V. R. Suvarna. &quot;Translation and
validation of brief patient health questionnaire against DSM IV as a tool to
diagnose major depressive disorder in Indian patients.&quot; Journal of postgraduate
medicine 53.2 (2007): 102.</li>
<li>Grover, Sandeep, Alakananda Dutt, and Ajit Avasthi. &quot;An overview of Indian
research in depression.&quot; Indian journal of psychiatry 52.Suppl1 (2010): S178.</li>
</ol>

CC BY-SA 3.0
2017-08-27T05:53:34.940Z
Excellent stuff Arka! Thank you for sharing your own research :)
Robin Kramer-ten Have
CC BY-SA 3.0
2017-08-27T05:31:49.167Z
2017-08-27T05:31:49.167Z
Outsider
<p>I am planning a study of an online intervention for depression in India. We were planning to use Patient Health Questionnaire-9 (PHQ-9) for assessing the depression symptom severity. One of our collaborators raised an important question in a recent meeting. He asked what is the validity of PHQ-9 in India and is there a possibility of using any other tool that is more valid?</p>

<p>I have searched the web and found some studies that have used PHQ-9 in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395288/" rel="nofollow noreferrer">adult</a> (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319265/" rel="nofollow noreferrer">another study</a>) as well as <a href="http://www.sciencedirect.com/science/article/pii/S1054139X12004077" rel="nofollow noreferrer">adolescent</a> populations in India. I also found a paper that developed a slightly modified version of PHQ-9, called <a href="http://repository.ias.ac.in/80134/1/80134.pdf" rel="nofollow noreferrer">PHQ-12</a>, for an Indian population.</p>

<p>I just wanted to know if there is any other tool that has been developed specifically for an Indian population or even any tool that has been well validated for an Indian population.</p>

CC BY-SA 3.0
2017-08-24T14:24:21.880Z
Thanks for the question! Can you please provide some references to what you are discussing (specifically your papers)? Just my 2 cents, but if you have a version of the tool specifically modified for an Indian population (and a publication on the validity and process), you probably aren't going to get much better than that ... What else would you demand of an instrument to be valid for your population?
mflo-ByeSE
CC BY-SA 3.0
2017-08-25T06:09:02.207Z
@mfloren I have added links to the relevant papers. PHQ-9 has been validated and used in many studies worldwide as well as in India. Whereas, the tool, PHQ-12, has only been used in two studies and the Journals are not peer-reviewed. So, I was a little skeptic of its acceptability to the international community. That is why I was trying to find out if there is anything that has been better validated.
Outsider
<measurement><depression><cross-cultural-psychology>
Which is the most valid/validated scale for diagnosis of Major depression for an Indian population?
Outsider
# Which is the most valid/validated scale for diagnosis of Major depression for an Indian population?

(Asked by: username_0 on 2017-08-23)

I am planning a study of an online intervention for depression in India. We were planning to use Patient Health Questionnaire-9 (PHQ-9) for assessing the depression symptom severity. One of our collaborators raised an important question in a recent meeting. He asked what is the validity of PHQ-9 in India and is there a possibility of using any other tool that is more valid?

I have searched the web and found some studies that have used PHQ-9 in [adult](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395288/) ([another study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319265/)) as well as [adolescent](http://www.sciencedirect.com/science/article/pii/S1054139X12004077) populations in India. I also found a paper that developed a slightly modified version of PHQ-9, called [PHQ-12](http://repository.ias.ac.in/80134/1/80134.pdf), for an Indian population.

I just wanted to know if there is any other tool that has been developed specifically for an Indian population or even any tool that has been well validated for an Indian population.

**Tags:** measurement, depression, cross-cultural-psychology

> **Comments:**
> **username_1**: Thanks for the question! Can you please provide some references to what you are discussing (specifically your papers)? Just my 2 cents, but if you have a version of the tool specifically modified for an Indian population (and a publication on the validity and process), you probably aren't going to get much better than that ... What else would you demand of an instrument to be valid for your population?  
> **username_0**: @mfloren I have added links to the relevant papers. PHQ-9 has been validated and used in many studies worldwide as well as in India. Whereas, the tool, PHQ-12, has only been used in two studies and the Journals are not peer-reviewed. So, I was a little skeptic of its acceptability to the international community. That is why I was trying to find out if there is anything that has been better validated.  

---

## 1 answers

### Answer by username_0 on 2017-08-27. Score: 3

I am sharing my research here should anybody find it useful.

=========================================================================

Although PHQ-9 wasn’t developed for an Indian audience, it has been used by multiple
studies in India [1, 2, 3]. It has also been validated for an adolescent population, and a
score of was found to have high sensitivity (87.1%) and specificity (79.7%) [4]. A
modified version of PHQ-9, the PHQ-12, was developed and validated on a South Indian
population of 100 participants. PHQ-12 essentially tests the same symptoms as PHQ-9
but differs in number of questions, the specific wordings of the questions, and the
marking scheme. PHQ-12 lets the patient mark every question in a ‘Yes’ or ‘No’. A
‘Yes’ is given a score of 1 and a ‘No’ a score of 0. A total score of >4 according to this

marking scheme has shown the highest sensitivity (92.0%) and specificity (90.7%) when
compared against PHQ-9 [5].
Other popular scales for diagnosis of depression - Hamilton Depression Rating Scale,
Beck Depression Inventory, and Montogomery Asberg Depression Rating Scale - have
been adapted for an Indian population [6, 7, 8]. Brief Patient Health Questionnaire has
also been translated into 11 Indian languages and validated for an Indian population [9].
A novel scale, Amritsar Depressive Inventory (ADI), has been developed based on
symptoms which are more prevalent in Indian populations [10].

1. Mehrotra, Seema, et al. "Profile of seekers of an internet-based self-help program
   for depression in India: observations and implications." International Journal Of
   Community Medicine And Public Health (2017).
2. Sidana, Surbhi, et al. "Prevalence of depression in students of a medical college in
   New Delhi: a cross-sectional study." The Australasian medical journal 5.5
   (2012): 247.
3. Thour, Amit, et al. "Depression among patients with diabetes mellitus in North
   India evaluated using patient health questionnaire-9." Indian journal of
   endocrinology and metabolism 19.2 (2015): 252.
4. Ganguly, Samrat, et al. "Patient health questionnaire-9 as an effective tool for
   screening of depression among Indian adolescents." Journal of Adolescent Health
   52.5 (2013): 546-551.
5. Poongothai, S., et al. "Reliability and validity of a modified PHQ-9 item
   inventory (PHQ-12) as a screening instrument for assessing depression in Asian
   Indians (CURES-65)." (2009).
6. Ajmany S, Nandi DN. Adaptation of A. T. Beck et al.'s "an inventory for
   measuring depression" Indian J Psychiatry 1973;15:386-90.
7. Ganguli M, Dube S, Johnston JM, Pandav R, Chandra V, Dodge HH. Depressive
   symptoms, cognitive impairment and functional impairment in a rural elderly
   population in India: A Hindi version of the geriatric depression scale (GDS-H).
   Int J Geriatr Psychiatry 1999;14:807-20.
8. Raguram R, Weiss MG, Channabasavanna SM, Devms GM. Stigma, depression,
   and somatization in south India. Am J Psychiatry 1996;1531043-9.
9. Kochhar, P. H., S. S. Rajadhyaksha, and V. R. Suvarna. "Translation and
   validation of brief patient health questionnaire against DSM IV as a tool to
   diagnose major depressive disorder in Indian patients." Journal of postgraduate
   medicine 53.2 (2007): 102.
10. Grover, Sandeep, Alakananda Dutt, and Ajit Avasthi. "An overview of Indian
    research in depression." Indian journal of psychiatry 52.Suppl1 (2010): S178.

> **Comments:**
> **username_2**: Excellent stuff Arka! Thank you for sharing your own research :)  

---

