Validation of PHQ-2 and PHQ-9 to Screen for Major Depression in the Primary Care Population

Datos Bibliográficos

ID23329763
AutoresBruce Arroll (0000-0002-0451-9462, University of Auckland), Felicity Goodyear‐Smith (0000-0002-6657-9401, University of Auckland), F Goodyear-Smith, Sue Crengle (0000-0001-9367-1492, University of Auckland), Jane Gunn (0000-0001-8836-7525, University of Auckland), Ngaire Kerse (0000-0002-5992-3681, University of Auckland), Tana Fishman (University of Auckland), Karen Falloon (0009-0009-5512-0863, University of Auckland), Simon Hatcher (0000-0003-3117-2350, University of Auckland)
Año2010
Volumen8
Número4
Páginas348-353
Fecha de publicación2010-07-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaThe Annals of Family Medicine (JOURNAL)
Identificadores de la revistaISSN: 1544-1709 • E-ISSN: 1544-1717
EditorialAnnals of Family Medicine (PUBLISHER)
DOI10.1370/afm.1139
PMID20644190
PMCIDPMC2906530
OpenAlexW2122884679
IdiomaEN
Citas recibidas147
Referencias citadas3

PURPOSE: Although screening for unipolar depression is controversial, it is potentially an efficient way to find undetected cases and improve diagnostic acumen. Using a reference standard, we aimed to validate the 2- and 9-question Patient Health Questionnaires (PHQ-2 and PHQ-9) in primary care settings. The PHQ-2 comprises the first 2 questions of the PHQ-9. METHODS: Consecutive adult patients attending Auckland family practices completed the PHQ-9, after which they completed the Composite International Diagnostic Interview (CIDI) depression reference standard. Sensitivities and specificities for PHQ-2 and PHQ-9 were analyzed. RESULTS: There were 2,642 patients who completed both the PHQ-9 and the CIDI. Sensitivity and specificity of the PHQ-2 for diagnosing major depression were 86% and 78%, respectively, with a score of 2 or higher and 61% and 92% with a score 3 or higher; for the PHQ-9, they were 74% and 91%, respectively, with a score of 10 or higher. For the PHQ-2 a score of 2 or higher detected more cases of depression than a score of 3 or higher. For the PHQ-9 a score of 10 or higher detected more cases of major depression than the PHQ determination of major depression originally described by Spitzer et al in 1999. CONCLUSIONS: We report the largest validation study of the PHQ-2 and PHQ-9, compared with a reference standard interview, undertaken in an exclusively primary care population. The PHQ-2 score or 2 or higher had good sensitivity but poor specificity in detecting major depression. Using a PHQ-2 threshold score of 2 or higher rather than 3 or higher resulted in more depressed patients being correctly identified. A PHQ-9 score of 10 or higher appears to detect more depressed patients than the originally described PHQ-9 scoring for major depression.

Anxiety · Anxiety disorder · CIDI · Depression (economics) · Depressive symptoms · Environmental health · Patient Health Questionnaire · Population · Psychiatry · Digital Mental Health Interventions · Medicine · Mental Health Treatment and Access · Treatment of Major Depression