Background: Undetected depression can result in a significant decline in
productivity among the workforce in every system, the healthcare sector
inclusive. It is vital to utilize brief screening tools to detect populations
at risk of depression. The 5-item WHO Well-being Index (WHO-5) has been used as
a screening measure for depression, but
research on this is scarce in sub-Saharan Africa. This study aimed to
determine the utility and validity of the WHO-5 in screening for depression in
a population of doctors and nurses in Nigeria during the COVID-19 pandemic. Methods: A representative sample of medical doctors and nurses across Nigeria (n = 464),
completed the 5-item World Health
Organization Well-Being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9). Results: The
pattern of factors associated with cases of a positive depression screening
was considerably similar for
the WHO-5 and the PHQ-9. At a cut-off score of 50 for the WHO-5, the
sensitivity and specificity values obtained
were 0.857 and 0.851 respectively. Positive and negative predictive
values were 0.404 and 0.981 respectively. ROC analysis of the WHO-5 against the
PHQ-9 revealed that, at a cut-off of 50, the sensitivity of the WHO-5 was
0.857, 1-specificity was 0.152. The AUC was 0.918 (95% CI 0.884-0.953). Also, there was a
strong, negative correlation between the WHO and the PHQ-9 scores (r = -0.590, p ≤ 0.0001). Conclusion: The WHO-5 well-being index has satisfactory validity as a
screening tool for the detection of depression. It is also feasible for use in
very busy settings, because of its brevity and ease of administration.
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