Suicidal ideation in persons with neurological conditions: prevalence, associations and validation of the PHQ-9 for suicidal ideation

Altura, K. Chelsea; Patten, Scott B.; Fiest, Kirsten M.; Atta, Callie; Bulloch, Andrew G. M.; Jetté, Nathalie

doi:10.1016/j.genhosppsych.2016.06.006

Cited by 47 publications

(54 citation statements)

References 32 publications

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“…Two quality items were consistently low scoring across all studies; prospective definition and/or mitigation of potential bias, and prior sample size calculations. A total of 5080 individuals were included in our review, although highly similar cohort characteristics between Amtmann et al (2014)(14) and Amtmann et al (2015)(15), also between Patten et al(19) and Altura et al(20) were apparent and raised the possibility that a number of participants (up to 12%) had been analysed twice (Table 2). Separately, one large study (n=3507; Gunzler et al (16)) provided 69% of the total number of participants.…”

Section: Study Characteristicsmentioning

confidence: 86%

“…Included studies were published between 2012 and 2017 by research groups based in the USA (n=4) (14–17) and Canada(n=3) (18–20). Overall study quality was high (mean quality score 75%, range 62.5 to 93.8; Table 1).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three studies(15,19,20) investigated the appropriateness of the PHQ-9 in pwMS with respect to its possible application for diagnosis, screening, and monitoring. Amtmann et al (2015)(15) measured the appropriateness of using the PHQ-9 as a diagnostic tool for major depressive disorder (MDD) against criterion standard telephone administration of the Structured Clinical Interview for DSM-IV Disorders (SCID), concluding that it was inadequate for use in this role due to its Youden Index (YI) being substantially lower than 0.8 (observed YI = 0.55) even when the cut-off was optimised.…”

Section: Findings On Phq-9 Performance Indicatorsmentioning

confidence: 99%

“…Altura et al (20) evaluated the appropriateness of the PHQ-9 as a screening tool for suicidal ideation, comparing the single PHQ-9 item on suicidal ideation against the criterion standard SCID item asking if the participant has had “recurrent thoughts of death, suicidal ideation, suicide attempt, or specific plan”. With a cut-point of one (any non-zero endorsement), the PHQ-9 exhibited sensitivity of 62.5%, specificity of 95%, PPV 41.7% and NPV of 97.8%.…”

Section: Findings On Phq-9 Performance Indicatorsmentioning

confidence: 99%

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Psychometric properties of the PHQ-9 depression scale in people with multiple sclerosis: a systematic review

Patrick

Connick

2018

Preprint

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30 Background: Depression affects approximately 25% of people with MS (pwMS) at any given time. It is 31 however under recognised in clinical practice, in part due to a lack of uptake for brief assessment tools 32 and uncertainty about their psychometric properties. The 9-item Patient Health Questionnaire (PHQ-9) is 33 an attractive candidate for this role. 34 35 Objective: To synthesise published findings on the psychometric properties of the 9-item Patient Health 36 Questionnaire (PHQ-9) when applied to people with multiple sclerosis (pwMS). 37 38 Data sources: PubMed, Medline and ISI Web of Science databases, supplemented by hand-searching of 39 references from all eligible sources. 40 41 Study eligibility criteria: Primary literature written in English and published following peer-review with 42 a primary aim to evaluate the performance of the PHQ-9 in pwMS. 43 44 Outcome measures: Psychometric performance with respect to appropriateness, reliability, validity, 45 responsiveness, precision, interpretability, acceptability, and feasibility. 46 47 Results: Seven relevant studies were identified, these were of high quality and included 5080 participants 48 from all MS disease-course groups. Strong evidence was found supporting the validity of the PHQ-9 as a Publications Ltd; 2006 Apr;12(2):204-8.388 6. Fernández-Jiménez E, Arnett PA. Impact of neurological impairment, depression, cognitive 389 function and coping on quality of life of people with multiple sclerosis: A relative importance 390 analysis. Multiple Sclerosis Journal. SAGE PublicationsSage UK: London, England; 2015

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Section: Study Characteristicsmentioning

confidence: 86%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Findings On Phq-9 Performance Indicatorsmentioning

confidence: 99%

Section: Findings On Phq-9 Performance Indicatorsmentioning

confidence: 99%

See 2 more Smart Citations

Psychometric properties of the PHQ-9 depression scale in people with multiple sclerosis: a systematic review

Patrick

Connick

2018

Preprint

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“…The PHQ-9 is a validated measure to identify suicidal thoughts, with sensitivity 65–90% and specificity 80–>90%. 16,17 We did not evaluate attempted or completed suicide or ART discontinuation due to psychiatric side effects. CNICS does not collect information on reasons for ART discontinuation or suicide attempts, and cause of death information is only available for a portion of the population.…”

Section: Methodsmentioning

confidence: 99%

The Relationship Between Efavirenz as Initial Antiretroviral Therapy and Suicidal Thoughts Among HIV-Infected Adults in Routine Care

Bengtson

Pence

Mollan

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Evidence about the effect of initiating efavirenz-containing combination antiretroviral therapy (ART) as first-line therapy on suicidal thoughts remains conflicting. Methods Using data from a cohort of HIV-infected adults enrolled in routine care across 5 sites in the United States, we included participants with a baseline patient-reported outcome measure and detectable viral load who initiated ART between 2011 and 2014. Participants were followed until the earliest of the following: first suicidal thoughts, discontinuation of initial ART regimen, death, loss to care (>12 months with no HIV appointments), or administrative censoring (2014 to 2015). Suicidal thoughts were measured using a Patient Health Questionnaire-9 item. We used weighted marginal structural Cox models to estimate the effect of initiating efavirenz-containing ART, versus efavirenz-free ART, on the hazard of active or passive suicidal thoughts after ART initiation, accounting for confounding by channeling bias. Results Overall, 597 participants were followed for a median of 19 months (13,132 total person-months); 147 (25%) initiated efavirenz-containing ART. At ART initiation, 38% of participants reported suicidal thoughts or depressive symptoms. Initiating efavirenz-based ART was associated with a hazard ratio (HR) for suicidal thoughts below the null in the crude analysis (HR 0.88 (95% CI 0.53, 1.45), and above the null in the weighted analysis (HR 1.21, 95% CI 0.66, 2.28). Among those with a prior mental health issue, the weighted HR was 1.76 (95% CI 0.45, 6.86). Conclusions After accounting for measured channeling bias, we observed no strong evidence that initiating efavirenz-containing ART increased the hazard of suicidal thoughts.

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Suicide in Children and Adults with Epilepsy: A Complex Relationship

Jones

Bordenave

2018

Suicide Prevention

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Suicidal ideation in persons with neurological conditions: prevalence, associations and validation of the PHQ-9 for suicidal ideation

Cited by 47 publications

References 32 publications

Psychometric properties of the PHQ-9 depression scale in people with multiple sclerosis: a systematic review

Psychometric properties of the PHQ-9 depression scale in people with multiple sclerosis: a systematic review

The Relationship Between Efavirenz as Initial Antiretroviral Therapy and Suicidal Thoughts Among HIV-Infected Adults in Routine Care

Suicide in Children and Adults with Epilepsy: A Complex Relationship

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