Screening And Diagnosis Of Depression In Rural Chiapas, Mexico

The purpose of the study was to validate the use of the (PHQ)‐2 and PHQ‐9 designed for Screening and Diagnosis of Depression. It began by providing details into why this research was necessary ,stating the necessity of the Patient Health Questionnaire (PHQ)‐2 and PHQ‐9 for screening and diagnosis of depression in primary health care with little information of its validity in rural, Spanish-speaking populations. Therefore the study seeks to validate the questionnaire in the marginalized community using the cross sectional design method of research between July and December 2014. Following a brief but clear introduction to the key variables of interest within their study, the authors provided background of mental disorders. The literature review provided by the authors was comprehensive and included a concise summary of the most pertinent research related to each of the variables included in their study. They also identified and noted variables in their study that were lacking in research base. The literature review provided a rationale for the author’s hypotheses, noting that the Spanish version of the questionnaire used in urban areas have been reported to be reliable and a valid measure of depression.

Seven medical students visited 152 households as part of a programmatic census and active case finding activity, and they invited all eligible adult residents to participate in the study (N = 250). Eligible participants were those who were 18 years or older, resided within the study catchment area, and were native-Spanish speakers. The students informed the potential participants about the study and asked for verbal informed consent. After obtaining informed consent, the medical students conducted a face-to-face interview using the PHQ-2, the PHQ-9, and the WHOQOL-BREF assessment questionnaires. A total of 223 (89%) people completed the interview. Those items that were not answered or understood by the participants were computed as missing data. Participants with a PHQ-9 score greater than 9 and those who reported self-harm ideation or attempts were referred to the clinic for further evaluation by the local physician. Additionally, in a random subset (10%) of participants with a PHQ-9 score greater than 9, a local psychiatrist, blind to the PHQ-9 results, conducted a second depression evaluation using the Hamilton Depression Rating Scale and clinical criteria. How the authors used sampling in the above data collection section It would be impossible to collect information from an entire population, therefore, the researchers selected individuals from their target group; a rural community in Mexico which to collect the data; this sample group from which the data is drawn is representative of the population ,studied, to obtain generalized data of the population as a whole in this case, the researchers (Seven medical students) through random selection chose participants from a sampling frame and variables of ages 18 and over were native-Spanish speakers within the 152 households visited and all eligible (meeting the measures of literacy, financial status (sociodemographic characteristics), were invited to participate making the research a random sample to part take in a questionnaire. The researchers also did not meddle with completed questionnaire, or answers from face to face interviews remaining neutral and unbiased.

The article matches the Cross-sectional design for quantitative research. It does this by the use of questionnaires, interviews, and comparing pre-existing statistical data, analyzing the data collected from a representative subset, at one specific point in time. The study accounted data from both the exposure and the outcome questionnaire as it relates to depression in the population within the study framework. It helped for establishing the odds and risk factors developing depression based on someone’s exposure status to a risk factor. This cross-sectional study was done in comparative to a similar study in urban areas allowing for the contrast of rural areas, whilst the researchers noted the limitations, stating only one rural community was researched it can be generalized thus their conclusion was consistent with their aim. Their study concluded that the PHQ-2 and PHQ-9 forms were beneficial tools for depression screening and diagnosis in rural, Spanish-speaking populations.