An intensive longitudinal study on interpretation issues with the PHQ instructions
Seizer L, Schiepek G (2026)
Publication Type: Journal article
Publication year: 2026
Journal
Book Volume: 408
Article Number: 121826
DOI: 10.1016/j.jad.2026.121826
Abstract
Concerns have been raised that PHQ-9 instructions (“bothered by” symptoms) conflict with frequency-based response options, potentially leading to some patients experiencing difficulty mapping lived experience onto response options and may conflate frequency with burden. We tested whether weekly PHQ-9 scores aligned more with symptom frequency or burden using an intensive longitudinal design. Depressed patients ( n = 23) reported daily symptom presence and burden ( n = 1290 days) and completed weekly PHQ-9 ( n = 236 weeks). Mixed-effects models decomposed within- and between-person effects and estimated patient-specific frequency–burden weights. Frequency and burden were highly correlated; each predicted PHQ-9 scores when modeled alone, but neither showed unique effects jointly. Thus, weekly PHQ-9 change may reflected a shared symptom-severity signal; person-level heterogeneity was suggested but uncertain. Findings are preliminary and should be interpreted alongside the PHQ-9's strong evidence base.
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Austria (AT)How to cite
APA:
Seizer, L., & Schiepek, G. (2026). An intensive longitudinal study on interpretation issues with the PHQ instructions. Journal of Affective Disorders, 408. https://doi.org/10.1016/j.jad.2026.121826
MLA:
Seizer, Lennart, and Günter Schiepek. "An intensive longitudinal study on interpretation issues with the PHQ instructions." Journal of Affective Disorders 408 (2026).
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