Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis

Gilbody, Simon; Richards, David; Brealey, Stephen; Hewitt, Catherine

doi:10.1007/s11606-007-0333-y

Cited by 1,085 publications

(874 citation statements)

References 56 publications

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“…Although our ability to diagnose major depression was limited by our use of a questionnaire to assess depressive symptoms and not a diagnostic interview, the questionnaire we used has been validated in our study population and has acceptable sensitivity and specificity compared to structured diagnostic interview. 17,18 Also, self-report of baseline factors such as physical inactivity, smoking, and BMI may not accurately reflect subsequent health behaviors over the follow-up period. Though we only measured depression at baseline and depression status may have changed over the course of follow-up, a related study in patients with diabetes found that over 70 % of patients with a PHQ-9 score ≥ 10 reported that they had been depressed for more than 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis of 14 studies found that the PHQ-9 threshold for a probable case of major depression had a pooled sensitivity of 80 % and specificity of 92 % compared to structured psychiatric interviews. 18 We also examined probable minor depression (defined as the presence of two to four depressive symptoms, one of which is either depressed mood or anhedonia, for more than half the days for at least 2 weeks) as a comparison condition, since prior studies have found minor depression was associated with increased healthcare costs, rehospitalization, and mortality in patients with chronic medical illnesses. [19][20][21] The sensitivity and specificity of the PHQ-9 for identifying a probable case of minor depression compared to structured psychiatric interview has been shown to be 77 % and 86 %, respectively.…”

Section: Primary Independent Variablementioning

confidence: 99%

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Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

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BACKGROUND: Hospitalizations for ambulatory caresensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate ambulatory care is provided, may be an important contributor to rising healthcare costs and public health burden. OBJECTIVE: To examine if probable major depression is independently associated with hospitalization for an ACSC in patients with diabetes. DESIGN: Secondary analysis of data from a prospective cohort study. PARTICIPANTS: Population-based cohort of 4,128 patients with diabetes ≥ 18 years old seen in primary care, who were enrolled between 2000 and 2002 and followed for 5 years (through 2007). MAIN MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire-9. Outcomes of interest included time to initial hospitalization for an ACSC and total number of ACSC-related hospitalizations. We used Cox proportional hazards regression models to ascertain an association between probable major depression and time to ACSC-related hospitalization, as well as Poisson regression for models examining probable major depression and number of ACSC-related hospitalizations. KEY RESULTS: Patients' mean age at study enrollment was 63.4 years (Standard Deviation: 13.4 years). Over the 5-year follow-up period, 981 patients in the study were hospitalized a total of 1,721 times for an ACSC, comprising 45.1 % of all hospitalizations. After adjusting for baseline demographic, clinical and health-risk behavioral factors, probable major depression was associated with initial ACSC-related hospitalization (Hazard Ratio: 1.41, 95 % Confidence Interval [95 % CI]: 1.15, 1.72) and number of ACSC-related hospitalizations (Relative Risk: 1.37, 95 % CI: 1.12, 1.68). CONCLUSIONS: Probable major depression in patients with diabetes is independently associated with hospitalization for an ACSC. Additional research is warranted to ascertain if effective interventions for depression in patients with diabetes could reduce the risk of hospitalizations for ACSCs and their associated adverse outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Primary Independent Variablementioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

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“…Respondents rate how much each symptom has been bothering them during the last two weeks using a 4-point scale from 0 ‘not at all’ to 3 ‘almost every day’. The instrument has shown good psychometric properties and adequate validity as a measure of symptoms of depression (Gilbody, Richards, Brealey, & Hewitt, 2007; Kroenke et al, 2001). …”

Section: Methodsmentioning

confidence: 99%

A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach

Cernvall

Sveen

Johannesson

et al. 2018

European Journal of Psychotraumatology

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Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.

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“…The PHQ-9 is a nine-item questionnaire that asks respondents to indicate the frequency with which they experience each of the nine symptoms considered in the diagnostic criteria for major depression [28]. The PHQ-9 has been shown to be a valid and reliable measure of depressive symptoms in patients with a variety of medical conditions [11,14,19].…”

Section: Methodsmentioning

confidence: 99%

A telephonic intervention for promoting occupational re-integration in work-disabled individuals with musculoskeletal pain

Sullivan

Simon

2012

Behav. Med. Pract. Policy Res.

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The purpose of the present research was to examine the feasibility of a telephonic occupational rehabilitation program. A sample of 23 individuals with chronic musculoskeletal pain was enrolled in the telephonic version of the Progressive Goal Attainment Program (PGAP-Tel). The PGAP-Tel is a risk-targeted intervention designed to reduce pain-related disability consequent to musculoskeletal injury. Treatment outcomes of PGAP-Tel were compared to a group of individuals with chronic musculoskeletal pain, who participated in the face-to-face format of the PGAP. Results showed that PGAP-Tel was acceptable to the majority of participants (76%) to whom it was offered. There were indications that engagement and adherence issues were more problematic in PGAP-Tel than in the face-to-face intervention. Both groups showed comparable reductions in pain, depression, fear of symptom exacerbation, and self-reported disability. Participants in the face-to-face intervention showed greater reduction in catastrophic thinking than participants in PGAP-Tel. Finally, 26% of participants in PGAP-Tel had resumed some form of employment at treatment termination compared to 56% of the participants in the face-to-face intervention. Given the low cost of the PGAP-Tel intervention and the accessibility advantages of a telephonic delivery, this type of intervention might be an important resource for targeting occupational disability in rural or remote communities when face-to-face services are not available.

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Screening for Depression in Medical Settings with the Patient Health Questionnaire (PHQ): A Diagnostic Meta-Analysis

Abstract: The PHQ9 is acceptable, and as good as longer clinician-administered instruments in a range of settings, countries, and populations. More research is needed to validate the PHQ2 to see if its diagnostic properties approach those of the PHQ9.

Cited by 1,085 publications

References 56 publications

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach

A telephonic intervention for promoting occupational re-integration in work-disabled individuals with musculoskeletal pain

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