Evaluation of the Patient Health Questionnaire-9 Item for Detecting Major Depression Among Adolescents

Bibliographic Data

ID23336116
AuthorsLaura Richardson (0000-0003-3634-4641, Seattle Children's Hospital), Laura P Richardson (0000-0002-0464-9398, Departments of Pediatrics and), Elizabeth Mccauley (0000-0001-9763-9262, Seattle Children's Research Institute, Seattle, Washington), David C Grossman (Departments of Pediatrics and), Carolyn A Mccarty (0000-0002-9747-0927, Departments of Pediatrics and), Julie Richards (0000-0002-7037-4177, Group Health Research Institute, Seattle, Washington; and), Joan Russo (0000-0002-2175-9441, University of Washington), Joan E Russo (Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington), Carol Rockhill (0000-0001-5799-9706, Seattle Children's Research Institute, Seattle, Washington), Wayne Katon (Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington)
Year2010
Volume126
Issue6
Pages1117-1123
Publication date2010-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePEDIATRICS (JOURNAL)
Journal identifiersISSN: 0031-4005 • E-ISSN: 1098-4275
PublisherAmerican Academy of Pediatrics (AAP) (PUBLISHER)
DOI10.1542/peds.2010-0852
PMID21041282
PMCIDPMC3217785
OpenAlexW2155298291
LanguageEN
Citations received93
References cited19

OBJECTIVE: The purpose of this study was to examine the performance characteristics and validity of the Patient Health Questionnaire-9 Item (PHQ-9) as a screening tool for depression among adolescents. METHODS: The PHQ-9 was completed by 442 youth (aged 13-17 years) who were enrolled in a large health care-delivery system and participated in a study on depression outcomes. Criterion validity and performance characteristics were assessed against an independent structured mental health interview (the Child Diagnostic Interview Schedule [DISC-IV]). Construct validity was tested by examining associations between the PHQ-9 and a self-report measure of functional impairment, as well as parental reports of child psychosocial impairment and internalizing symptoms. RESULTS: A PHQ-9 score of 11 or more had a sensitivity of 89.5% and a specificity of 77.5% for detecting youth who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for major depression on the DISC-IV. Receiver-operator-curve analysis revealed that the PHQ-9 had an area under the curve of 0.88 (95% confidence interval: 0.82-0.94), and the cut point of 11 was optimal for maximizing sensitivity without loss of specificity. Increasing PHQ-9 scores were significantly correlated with increasing levels of functional impairment, as well as parental report of internalizing symptoms and psychosocial problems. CONCLUSIONS: Although the optimal cut point is higher among adolescents, the sensitivity and specificity of the PHQ-9 are similar to those of adult populations. The brief nature and ease of scoring of this instrument make this tool an excellent choice for providers and researchers seeking to implement depression screening in primary care settings.

Anxiety · Confidence interval · Depression (economics) · Depressive symptoms · Mental health · Patient Health Questionnaire · Psychiatry · Psychosocial · Receiver operating characteristic · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Internal Medicine · Medicine · Mental Health Treatment and Access · Suicide and Self-Harm Studies