Biological and clinical correlates of the patient health questionnaire-9: exploratory cross-sectional analyses of the baseline health study

Abstract

ObjectivesWe assessed the relationship between the Patient Health Questionnaire-9 (PHQ-9) at intake and other measurements intended to assess biological factors, markers of disease and health status.Design, setting and participantsWe performed a cross-sectional analysis of 2365 participants from the Baseline Health Study, a prospective cohort of adults selected to represent major demographic groups in the USA. Participants underwent deep phenotyping on demographic, clinical, laboratory, functional and imaging findings.ImportanceDespite extensive research on the clinical implications of the PHQ-9, data are limited on the relationship between PHQ-9 scores and other measures of health and disease; we sought to better understand this relationship.InterventionsNone.Main outcomes and measuresCross-sectional measures of medical illnesses, gait, balance strength, activities of daily living, imaging and laboratory tests.ResultsCompared with lower PHQ-9 scores, higher scores were associated with female sex (46.9%–66.7%), younger participants (53.6–42.4 years) and compromised physical status (higher resting heart rates (65 vs 75 bpm), larger body mass index (26.5–30 kg/m2), greater waist circumference (91–96.5 cm)) and chronic conditions, including gastro-oesophageal reflux disease (13.2%–24.7%) and asthma (9.5%–20.4%) (p<0.0001). Increasing PHQ-9 score was associated with a higher frequency of comorbidities (migraines (6%–20.4%)) and active symptoms (leg cramps (6.4%–24.7%), mood change (1.2%–47.3%), lack of energy (1.2%–57%)) (p<0.0001). After adjustment for relevant demographic, socioeconomic, behavioural and medical characteristics, we found that memory change, tension, shortness of breath and indicators of musculoskeletal symptoms (backache and neck pain) are related to higher PHQ-9 scores (p<0.0001).ConclusionsOur study highlights how: (1) even subthreshold depressive symptoms (measured by PHQ-9) may be indicative of several individual- and population-level concerns that demand more attention; and (2) depression should be considered a comorbidity in common disease.Trial registration numberNCT03154346.

Identifying characteristics and clinical conditions associated with hand grip strength in adults: the Baseline Health Study

“…All study procedures and study data collection are conducted in accordance with the principles described in the Declaration of Helsinki and with relevant local, state, national, and international standards. Detailed descriptions of study procedures and methods, including exclusion and inclusion criteria and institutional review board approval and enrollment procedures, have been published [83,84].…”

“…The Project Baseline Health Study (PBHS) is a prospective cohort study of U.S. adults that has collected a wide array of personal, behavioral, and clinical characteristics that together comprise data sufficiently rich to allow deep phenotyping of study participants [83,84]. In this analysis, we examined participants in the BHS study cohort to identify the most salient factors associated with HGS by examining demographic, socioeconomic status-related health behaviors, medical conditions, symptoms, patient-reported outcomes, and laboratory measures across a wide adult age group while stratifying by age and sex to account for expected differences between these groups.…”

Comprehensive Assessment of Health Impacts from Exposure to Nonionizing Radiation for Healthcare Practitioners Working with MRI and Ultrasound

“…Therefore, the use of questionnaires for self-assessment of the quality of the state of health was justified. It was found that higher PHQ-9 scores were associated with female gender, young age, high body mass index, chronic diseases, higher incidence of comorbidities, and acute diseases (leg cramps, mood changes, lack of energy (p <0:0001) [58].…”

Identifying Factors Associated with Lower Quarter Performance-Based Balance and Strength Tests: the Project Baseline Health Study

“…A full description of study procedures and design, inclusion and exclusion criteria, and institutional review board approval has been previously made available. 17,18 This study used cross-sectional data from the first in-person study collection time point; selfreported data used were collected at either the same in-person timepoint or via remote application. We limited data that were only collected remotely to participant responses within 200 days of participants' initial in-person data collection.…”

“…Any desire to estimate related causal effects will require an alternative methodological approach. [46][47][48] Second, while the PBHS participants are overall representative of U.S. adult age, sex, race, and ethnicity 18 and were recruited and enrolled at multiple sites, these sites were limited to two states (California and North Carolina) which may limit our ability to generalize these results to adults in other regions of the U.S.. In this study, we identified several novel salient factors with the SLBT, SRT, and 30CST when stratifying by age (<65 and ≥65 years) -many of them common across the three tests.…”