Citation

Malpass A, Shaw A, Kessler D, Sharp D. Br. J. Gen. Pract. 2010; 60(575): e231-238.

Copyright

(Copyright © 2010, Royal College of General Practitioners)

DOI

10.3399/bjgp10X502119

PMID

20529486

PMCID

PMC2880764

Abstract

BACKGROUND: In 2009, a new indicator (DEP 3) was introduced into the Quality and Outcomes Framework. GPs are now encouraged to assess response to antidepressant treatment 5-12 weeks after the initial assessment, to guide clinical decision making. The Patient Health Questionnaire (PHQ-9) is one of the validated instruments that GPs can use to assess the patient's clinical state.
AIMS: To explore the extent to which changes in PHQ-9 score over time reflect patients' accounts of their experiences of depression during the same period; and to explore patients' experiences of using the PHQ-9 within primary care consultations.
DESIGN OF STUDY: Mixed methods.
SETTING: Primary care.
METHOD: Patients were recruited through six GP practices. The PHQ-9 and in-depth interviews were used at the same three time points over a 6-month period during a new or first episode of depression.
RESULTS: Patterns in the total PHQ-9 score broadly reflected patients' accounts of the severity of their depression over time. However, the PHQ-9 was inaccurate in its assessment of the presence and intensity of thoughts of self-harm, and missed symptoms that are meaningful to patients. At the diagnostic primary care consultation, patients viewed their score as a 'tangible' measure of their condition. Some patients requested the PHQ-9 subsequently as a way to measure their own treatment response and recovery process.
CONCLUSION: The potential therapeutic value of the PHQ-9 may be dependent upon the GP's willingness to openly discuss the results and what they may mean for the patient.

Language: en

Keywords

Humans; Adult; Aged; Female; Male; Middle Aged; Adolescent; Decision Making; Young Adult; Psychiatric Status Rating Scales; Treatment Outcome; Surveys and Questionnaires; Referral and Consultation; Antidepressive Agents; Depressive Disorder; Family Practice; Professional Practice