Abstract
Background: Depression symptoms are a mental health problem with rising prevalence globally. To enhance the estimation of depressive symptoms in epidemiological studies, a 9-item Patient Health Questionnaire (PHQ-9) has been widely used. Some local research found that a single-item General Happiness Index (GHI) highly correlated with the scales used for screening the depressive symptoms. This study hence aimed to explore the sensitivity and specificity of GHI for screening mild or more severe depressive symptoms based on the secondary data analysis in the Chinese population.
Methods: This methodological study used the data collected in the General Happiness Survey 2024 and 2025 in Hong Kong (Lam et al., 2025). Demographics, GHI (0-10) and PHQ-9 (0-27) were available in the collected data. Pearson correlation analysis was used to indicate the relationship between GHI and PHQ-9. To identify the optimal sensitivity and specificity, receiver operator characteristic (ROC) curves were used to identify the best cutoff value of the GHI for mild depressive symptoms measured by PHQ-9 (score > 5).
Results: Of those 1,093 samples (from 2024 data) and 2,072 samples (from 2025 data) with about 68.0-70.2% females were included in the analysis. The age range of 35-44 years old participants (30.5-35.5%) accounted for the largest sample. The mean of GHI was 5.60-5.95, while that of PHQ-9 was 9.06-11.4 (SD 6.6-6.8).
A total of 904 (from 2024 data) and 647 participants (from 2025 data) was identified as mild or more severe depressive symptoms. GHI consistently, significantly and negatively correlated with PHQ-9 (r = -0.494 to -0.468, p<0.001). Based on the ROC analysis, an optimal cutoff value of GHI was 7 or less with sensitivity 65.3-68.0% and specificity 68.6-81.0% for identifying mild or more severe depressive symptoms. The Area Under the Curve was 74.0-79.2%.
Conclusion: The cutoff value of 7 of a single item GHI was recommended to screen the mild or more severe depressive symptoms with acceptable sensitivity and specificity. However, it is of caution that the reproducibility of the similar results may not be secured.
Notes
References:
Lam, S. C., Chan, S., Tsui, K. Y., & Odetayo, A. (2025). General happiness index of a repeated cross-sectional survey among the general population from 2018 to 2024 in Hong Kong: A data note. BMC Research Notes, 18(1), 1-4. https://doi.org/10.1186/s13104-025-07399-6
Additional references listed in attached slide deck.
Sigma Membership
Pi Iota at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Mixed/Multi Method Research
Keywords:
Public and Community Health, Primary Care, Instrument and Tool Development, Mental Depression, Happiness
Recommended Citation
Chan, Shun; Odetayo, Aderonke; Cheung, Jasmine; Tang, Anson Chui Yan; Suen, Lorna Kawi Ping; and Lam, Simon Ching, "Diagnostic Accuracy of a Single-Item Happiness Index for Screening Mild Depressive Symptoms" (2026). International Nursing Research Congress (INRC). 176.
https://www.sigmarepository.org/inrc/2026/presentations_2026/176
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-20
Diagnostic Accuracy of a Single-Item Happiness Index for Screening Mild Depressive Symptoms
Toronto, Ontario, Canada
Background: Depression symptoms are a mental health problem with rising prevalence globally. To enhance the estimation of depressive symptoms in epidemiological studies, a 9-item Patient Health Questionnaire (PHQ-9) has been widely used. Some local research found that a single-item General Happiness Index (GHI) highly correlated with the scales used for screening the depressive symptoms. This study hence aimed to explore the sensitivity and specificity of GHI for screening mild or more severe depressive symptoms based on the secondary data analysis in the Chinese population.
Methods: This methodological study used the data collected in the General Happiness Survey 2024 and 2025 in Hong Kong (Lam et al., 2025). Demographics, GHI (0-10) and PHQ-9 (0-27) were available in the collected data. Pearson correlation analysis was used to indicate the relationship between GHI and PHQ-9. To identify the optimal sensitivity and specificity, receiver operator characteristic (ROC) curves were used to identify the best cutoff value of the GHI for mild depressive symptoms measured by PHQ-9 (score > 5).
Results: Of those 1,093 samples (from 2024 data) and 2,072 samples (from 2025 data) with about 68.0-70.2% females were included in the analysis. The age range of 35-44 years old participants (30.5-35.5%) accounted for the largest sample. The mean of GHI was 5.60-5.95, while that of PHQ-9 was 9.06-11.4 (SD 6.6-6.8).
A total of 904 (from 2024 data) and 647 participants (from 2025 data) was identified as mild or more severe depressive symptoms. GHI consistently, significantly and negatively correlated with PHQ-9 (r = -0.494 to -0.468, p<0.001). Based on the ROC analysis, an optimal cutoff value of GHI was 7 or less with sensitivity 65.3-68.0% and specificity 68.6-81.0% for identifying mild or more severe depressive symptoms. The Area Under the Curve was 74.0-79.2%.
Conclusion: The cutoff value of 7 of a single item GHI was recommended to screen the mild or more severe depressive symptoms with acceptable sensitivity and specificity. However, it is of caution that the reproducibility of the similar results may not be secured.
Description
Depressive symptoms screening study in Hong Kong analyzed a single-item General Happiness Index (GHI; 0–10) vs a 9-item Patient Health Questionnaire (PHQ-9; 0–27) using 2024–2025 survey data (n=3,165). GHI negatively correlated with PHQ-9 (r≈-0.47, p<0.001). ROC curves analysis showed GHI ≤7 best identified mild or worse depressive symptoms (PHQ-9 > 5) with sensitivity 65–68%, specificity 69–81%, AUC 74–79%. GHI cutoff of 7 is recommended, though reproducibility remains uncertain.