Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics

Steenbergen-Weijenburg, Kirsten M van; Vroege, Lars de; Ploeger, R.; Brals, J.W.; Vloedbeld, Martijn G; Veneman, Thiemo F.; Roijen, Leona Hakkaart-van; Rutten, Frans; Beekman, Aartjan T.F.; Feltz-Cornelis, Christina M. van der

doi:10.1186/1472-6963-10-235

Cited by 161 publications

(127 citation statements)

References 12 publications

(16 reference statements)

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“…It has demonstrated good psychometric properties in diabetic patients [73]. Another instrument we find useful is the HADS (Hospital Anxiety and Depression Scale), which has also been used for screening purposes in studies of diabetic patients [74,75].…”

Section: Screening For Depression and Anxiety In Dpnp Patientsmentioning

confidence: 98%

Painful Diabetic Neuropathy is More than Pain Alone: Examining the Role of Anxiety and Depression as Mediators and Complicators

Jain

Raison

et al. 2011

Curr Diab Rep

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A wealth of information exists regarding the plight of patients suffering with diabetic peripheral neuropathic pain (DPNP). Although physical pain is certainly a primary challenge in the management of this condition, disorders associated with emotional pain-especially depression and anxiety-also greatly complicate the clinician's efforts to attain optimal outcomes for DPNP patients. This article reviews the high rate of comorbidity between DPNP and depression/anxiety with a focus on why this pattern of comorbidity exists and what can be done about it. To accomplish this, the many physiologic similarities between neuropathic pain and depression/anxiety are reviewed as a basis for better understanding how, and why, optimal treatment strategies use behavioral and pharmacologic modalities known to improve both physical pain and symptoms of depression and anxiety. We conclude by highlighting that screening, diagnosing, and optimally treating comorbid depression/anxiety not only improves quality of life, these but also positively impacts DPNP pain.

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Section: Screening For Depression and Anxiety In Dpnp Patientsmentioning

confidence: 98%

Painful Diabetic Neuropathy is More than Pain Alone: Examining the Role of Anxiety and Depression as Mediators and Complicators

Jain

Raison

et al. 2011

Curr Diab Rep

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“…Patients' admission and follow-up notes were reviewed to complete and confirm clinical variables and CT scan findings. During this study, the PHQ-9 was used and it has been validated in a number of studies with a sensitivity of 80% and specificity of 78% using a cutoff of ≥10 18,19 . The study participants were then classified according to the PHQ-9 total severity score.…”

Section: Ethical Consideration and Informed Consentmentioning

confidence: 99%

Post-stroke depression among stroke survivors attending two hospitals in Kampala Uganda

Gyagenda¹,

Ddumba²,

Odokonyero³

et al. 2016

Afr H. Sci.

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Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a standardized questionnaire. The Patient Health Questionnaire-9 was used to assess for depression among non-aphasic patients while the Aphasic Depression Rating Scale was administered to aphasic patients. Univariable and multivariable analyses performed to describe associations with PSD. Results: Forty three females (58.9%) and 30 males (41.1%) who had a stroke participated. Fifty eight (79.5%) had ischemic strokes and 12 participants (16.4%) were aphasic. The prevalence of PSD among the study participants was 31.5%. PSD was higher among patients assessed within 6 months after the onset of stroke. PSD was strongly associated with the total Barthel index of activities of daily living (BIADL) score; p=0.001. There was no significant association between demographic characteristics and PSD. Conclusion: There is a high prevalence of unrecognized post-stroke depression. Post-stroke depression was strongly associated with the patient's inability to undertake activities of daily life. There is urgent need for integration of screening for and management of post-stroke depression among stroke survivors.

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“…22 Importantly, the PHQ-9 has been validated in patients with diabetes. 23,24 Covariates of Interest…”

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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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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Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics

Cited by 161 publications

References 12 publications

Painful Diabetic Neuropathy is More than Pain Alone: Examining the Role of Anxiety and Depression as Mediators and Complicators

Painful Diabetic Neuropathy is More than Pain Alone: Examining the Role of Anxiety and Depression as Mediators and Complicators

Post-stroke depression among stroke survivors attending two hospitals in Kampala Uganda

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

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