Adaptation of the patient health questionnaire-8 as a self-rated suicide risk screening instrument among the family caregivers of Nigerian patients with depressive disorders

Abstract

Background: The assessment of suicide risk has been neglected among the family caregivers (FCs) of patients with depressive disorders. Objectives: The objective was to examine the validity, reliability, and suicide risk screening characteristics of the PHQ-8 in a sample of Nigerian FCs of patients with psychiatric disorders specifically depressive disorders. Methods: A total of 262 FC-patient dyads were consecutively recruited adopting a convenience sampling technique from two tertiary healthcare facilities in Southwestern Nigeria. Their FCs completed the PHQ-8, the General Health Questionnaire-12 (GHQ-12), and the Zarit Burden Interview (ZBI). Suicide risk level was assessed by interviewing them with the Mini International Neuropsychiatric Interview (MINI) suicidality module. The patients completed the Hamilton Depression Rating Scale (HDRS), and their functioning was evaluated with the Global Assessment of Functioning (GAF) Scale. Results: The Cronbach's alpha for the PHQ-8 items was 0.80. It demonstrated satisfactory construct validity with the FC score on the ZBI (P < 0.001), GHQ-12 (P < 0.001), and patients' HDRS (P < 0.001), and GAF (P < 0.001) scores. Logistic regression revealed that only the FCs' PHQ-8 score was positively associated with their suicide risk status. Applying the receiver operating characteristics curve, the best cutoff score for those with high-suicide risk was 8 (sensitivity 0.889, specificity 0.850). Conclusions: The PHQ-8 has satisfactory screening properties as a suicide risk assessment tool among the FCs of Nigerian patients with depressive disorders.

Keywords

• Nigerian family caregivers
• Patient Health Questionaire-8
• sensitivity
• specificity
• suicide risk