Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Apr;22(4):478-486.
doi: 10.1111/papr.13107. Epub 2022 Mar 12.

Examining the psychometric properties of brief screening measures of depression and anxiety in chronic pain: The Patient Health Questionnaire 2-item and Generalized Anxiety Disorder 2-item

Madelyne A Bisby  1 , Eyal Karin  1 , Amelia J Scott  1 , Joanne Dudeney  1 , Alana Fisher  1 , Milena Gandy  1 , Taylor Hathway  1 , Andreea I Heriseanu  1 , Lauren Staples  1 , Nickolai Titov  1 , Blake F Dear  1
Affiliations
Meta-Analysis

Examining the psychometric properties of brief screening measures of depression and anxiety in chronic pain: The Patient Health Questionnaire 2-item and Generalized Anxiety Disorder 2-item

Madelyne A Bisby et al. Pain Pract. 2022 Apr.

Abstract

Objective: Individuals with chronic pain experience anxiety and depressive symptoms at rates higher than the general population. The Patient Health Questionnaire 2-item (PHQ-2) and Generalized Anxiety Disorder 2-item (GAD-2) are brief screening measures of depression and anxiety, respectively. These brief scales are well-suited for use in routine care due to their brevity and ease of administration, yet their psychometric properties have not been established in heterogeneous chronic pain samples when administered over the Internet.

Materials and methods: Using existing data from randomized controlled trials of an established Internet-delivered pain management program (n = 1333), we assessed the reliability, validity, diagnostic accuracy, and responsiveness to treatment change in the PHQ-2 and GAD-2, as well as the long-form counterparts. Exploratory analyses were conducted to obtain cutoff scores using those participants with diagnostic data (n = 62).

Results: The PHQ-2 and GAD-2 demonstrated appropriate reliability (eg, Cronbach's α = 0.79-0.84), validity (eg, higher scores in individuals with a diagnosis; p < 0.001), and responsiveness to treatment change (eg, pre- to post-treatment scores, p < 0.001). The psychometric properties of the short forms compared well with the longer forms. Cutoff scores on the short forms were consistent with general population samples, while cutoff scores on the long forms were higher than previously observed using general population samples. All four scales favored specificity over sensitivity.

Conclusions: The PHQ-2 and GAD-2 demonstrated acceptable psychometric properties in the current sample, as did the long forms. Based on our findings, the PHQ-2 and GAD-2 can be used as screening tools with chronic pain samples when administered over the Internet.

Keywords: anxiety; chronic pain; depression; measurement.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Elbinoune I, Amine B, Shyen S, Gueddari S, Abouqal R, Hajjaj‐Hassouni N. Chronic neck pain and anxiety‐depression: prevalence and associated risk factors. Pan Afr Med J. 2016;24:1–8. - PMC - PubMed
    1. Lerman SF, Rudich Z, Brill S, Shalev H, Shahar G. Longitudinal associations between depression, anxiety, pain, and pain‐related disability in chronic pain patients. Psychosom Med. 2015;77(3):333–41. - PubMed
    1. Siqueira‐Campos VM, Da Luz RA, de Deus JM, Martinez EZ, Conde DM. Anxiety and depression in women with and without chronic pelvic pain: prevalence and associated factors. J Pain Res. 2019;12:1223–33. - PMC - PubMed
    1. Tseli E, Boersma K, Stålnacke B‐M, Enthoven P, Gerdle B, Äng BO, et al. Prognostic factors for physical functioning after multidisciplinary rehabilitation in patients with chronic musculoskeletal pain. Clin J Pain. 2019;35(2):148–73. - PMC - PubMed
    1. Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, Mccracken LM. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain. 2016;157(7):1472–9. - PMC - PubMed

Publication types