Which is the most valid/validated scale for diagnosis of Major depression for an Indian population? I am planning a study of an online intervention for depression in India. We were planning to use Patient Health Questionnaire-9 (PHQ-9) for assessing the depression symptom severity. One of our collaborators raised an important question in a recent meeting. He asked what is the validity of PHQ-9 in India and is there a possibility of using any other tool that is more valid?

I have searched the web and found some studies that have used PHQ-9 in adult (another study) as well as adolescent populations in India. I also found a paper that developed a slightly modified version of PHQ-9, called PHQ-12, for an Indian population.

I just wanted to know if there is any other tool that has been developed specifically for an Indian population or even any tool that has been well validated for an Indian population.
I am sharing my research here should anybody find it useful.

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Although PHQ-9 wasn’t developed for an Indian audience, it has been used by multiple
studies in India [1, 2, 3]. It has also been validated for an adolescent population, and a
score of was found to have high sensitivity (87.1%) and specificity (79.7%) [4]. A
modified version of PHQ-9, the PHQ-12, was developed and validated on a South Indian
population of 100 participants. PHQ-12 essentially tests the same symptoms as PHQ-9
but differs in number of questions, the specific wordings of the questions, and the
marking scheme. PHQ-12 lets the patient mark every question in a ‘Yes’ or ‘No’. A
‘Yes’ is given a score of 1 and a ‘No’ a score of 0. A total score of &gt;4 according to this

marking scheme has shown the highest sensitivity (92.0%) and specificity (90.7%) when
compared against PHQ-9 [5].
Other popular scales for diagnosis of depression - Hamilton Depression Rating Scale,
Beck Depression Inventory, and Montogomery Asberg Depression Rating Scale - have
been adapted for an Indian population [6, 7, 8]. Brief Patient Health Questionnaire has
also been translated into 11 Indian languages and validated for an Indian population [9].
A novel scale, Amritsar Depressive Inventory (ADI), has been developed based on
symptoms which are more prevalent in Indian populations [10].


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