Reliability and score ranges of the PHQ-9 and GAD-7 in a primary and secondary care mental health service

Abstract

The reliability of the PHQ-9 and GAD-7 as measures of depression and anxiety is well established in primary care. The present study evaluates whether or not differences occur for patients cared within a primary versus secondary mental health service. Pre-treatment scores for patients were included in a cross-sectional cohort design. Reliability of the PHQ-9 and the GAD-7 ranged from “acceptable” to “excellent”. Reliability and overall scores did not significantly differ between services. However many clients in both groups scored the maximum score on the GAD-7 and there were few differences in scores based on diagnosis for both measures. The PHQ-9 and the GAD-7 are reliable measures of depression and anxiety symptoms for patients cared within a primary or secondary mental health service. However, the GAD-7 has a ceiling effect and both measures may not distinguish between services and diagnosis and therefore may not be useful for screening purposes.

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ORCID for Thomas Richardson: orcid.org/0000-0002-5357-4281

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