Citation

Corson K, Gerrity MS, Dobscha SK. Am. J. Manag. Care 2004; 10(11 Pt 2): 839-845.

Copyright

(Copyright © 2004, Intellisphere)

DOI

unavailable

PMID

15609737

Abstract

OBJECTIVE: To evaluate the psychometric properties of a single-item depression screen against validated scoring algorithms for the Patient Health Questionnaire (PHQ) and the utility of these algorithms in screening for depression and suicidality in a Department of Veterans Affairs (VA) primary care setting.
STUDY DESIGN: Recruitment phase of a randomized trial.
METHODS: A total of 1211 Portland VA patients with upcoming primary care clinic appointments were administered by telephone a single item assessing depressed mood over the past year and the PHQ. The PHQ-9 (9 items) encompasses DSM-IV criteria for major depression, the PHQ-8 (8 items) excludes the thoughts of death or suicide item, and the PHQ-2 (2 items) assesses depressed mood and anhedonia. Patients whose responses suggested potential suicidality were administered 2 additional items assessing suicidal ideation. Patients receiving mental health specialty care were excluded.
RESULTS: Using the PHQ-9 algorithm for major depression as the reference standard, the VA single-item screen was specific (88%) but less sensitive (78%). A PHQ-2 score of > or =3 demonstrated similar specificity (91%) with high sensitivity (97%). For case finding, the PHQ-8 was similar to the PHQ-9. Approximately 20% of patients screened positive for moderate depression, 7% reported thoughts of death or suicide, 2% reported thoughts of harming themselves, and 1% had specific plans.
CONCLUSIONS: The PHQ-2 offers brevity and better psychometric properties for depression screening than the single-item screen. The PHQ-9 item assessing thoughts of death or suicide does not improve depression case finding; however, one third of patients endorsing this item reported recent active suicidal ideation.

Language: en

Keywords

Aged; Algorithms; Community Health Centers; Depressive Disorder; Female; Humans; Male; Mass Screening; Middle Aged; Oregon; Outpatient Clinics, Hospital; Patient Selection; Primary Health Care; Psychiatric Status Rating Scales; Psychometrics; Self-Assessment; Suicide; Surveys and Questionnaires; Telephone; United States; United States Department of Veterans Affairs; Veterans