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. 2023 Apr;27(4):1154-1161.
doi: 10.1007/s10461-022-03852-w. Epub 2022 Oct 8.

Does It Matter What Screener We Use? A Comparison of Ultra-brief PHQ-4 and E-mwTool-3 Screeners for Anxiety and Depression Among People With and Without HIV

Cale N Basaraba  1 , Melissa A Stockton  2 , Annika Sweetland  3 , Andrew Medina-Marino  4   5   6 , Kathryn L Lovero  7 , Maria A Oquendo  4 , M Claire Greene  8 , Ana Olga Mocumbi  9 , Lidia Gouveia  9   10 , Milena Mello  2 , Palmira Dos Santos  9   10 , Antonio Suleman  9 , Dirceu Mabunda  9 , Flávio Mandlate  9 , Amalio Xavier  10 , Wilza Fumo  9   10 , Luciana Massinga  9 , Saida Khan  10 , Paulino Feliciano  9 , Bianca Kann  2 , Andre Fiks Salem  2 , Charl Bezuidenhout  11 , Jennifer J Mootz  2 , Cristiane S Duarte  2 , Francine Cournos  12 , Melanie M Wall  13   2   14 , Milton L Wainberg  2
Affiliations

Does It Matter What Screener We Use? A Comparison of Ultra-brief PHQ-4 and E-mwTool-3 Screeners for Anxiety and Depression Among People With and Without HIV

Cale N Basaraba et al. AIDS Behav. 2023 Apr.

Abstract

The burden of depression and anxiety disorders is high in sub-Saharan Africa, especially for people with HIV (PWH). The Patient Health Questionnaire-4 (PHQ-4) and Electronic Mental Wellness Tool-3 (E-mwTool-3) are ultra-brief screening tools for these disorders. We compared the performance of PHQ-4 and E-mwTool-3 for screening MINI-International Neuropsychiatric Interview diagnoses of depression and anxiety among a sample of individuals with and without HIV in two primary care clinics and one general hospital in Maputo City, Mozambique. Areas-under-the-curve (AUC) were calculated along with sensitivities and specificities at a range of cutoffs. For PWH, at a sum score cutoff of ≥ 1, sensitivities were strong: PHQ-4:Depression = 0.843; PHQ-4:Anxiety = 0.786; E-mwTool-3:Depression = 0.843; E-mwTool-3:Anxiety = 0.929. E-mwTool-3 performance was comparable to PHQ-4 among people with and without HIV.

Keywords: Anxiety; Brief screeners; Depression; GAD-2; HIV; PHQ-2; PHQ-4; Sub-Saharan Africa.

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Conflict of interest statement

Conflict of interest Dr. Oquendo reports receipt of royalties from the Research Foundation for Mental Hygiene for the commercial use of the Columbia Suicide Severity Rating Scale. She serves as an advisor to Alkermes, Otsuka, Mind Medicine, St. George’s University and Fundacion Jimenez Diaz. Her family owns stock in Bristol Myers Squibb. The other authors report no financial relationships with commercial interests.

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