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patient health questionniare 9 (PHQ9)

Indications: - screening for depression Procedure: Over the last 2 weeks, how often have you been bothered by any of the following problems? Part 1 Select & score each of the 9 items from the following: 0 = Not at all 1 = Several days 2 = More than half the days 3 = Nearly every day 1) Little interest or pleasure in doing things 2) Feeling down, depressed, or hopeless 3) Trouble falling asleep, staying asleep, or sleeping too much 4) Feeling tired or having little energy 5) Poor appetite or overeating 6) Feeling bad about yourself, feeling that you are a failure, or feeling that you have let yourself or your family down 7) Trouble concentrating on things such as reading the newspaper or watching television 8) Moving or speaking so slowly that other people could have noticed. Or being so fidgety or restless that you have been moving around a lot more than usual 9) Thinking that you would be better off dead or that you want to hurt yourself in some way Interpretation: Major Depressive Syndrome is suggested if: 1) Of the 9 items, 5 or more are circled as 2 or 3 2) Either item 1 or 2 is positive, that 2 or 3 Minor Depressive Syndrome is suggested if: 1) Of the 9 items, 2, 3, or 4 are circled 2 or 3 2) Either item 1 or 2 is positive, that is, 2 or 3 Total score: <4 suggests the patient may not need depression treatment <5 is goal of treating major depression [6] > 5-14: physician uses clinical judgment about treatment, based on patient's duration of symptoms and functional impairment. >15: warrants treatment for depression, using antidepressant, psychotherapy &/or a combination of treatment >19: severe major depression warrants treatment for depression, using antidepressant & psychotherapy [6] a cutoff score of >= 10 maximizes sensitivity & specificity [4] Part 2 For items scored 1-3, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? 0 = Not Difficult At All 1 = Somewhat Difficult 2 = Very Difficult 3 = Extremely Difficult A 2 or 3 suggests that the patient's functionality is impaired. After treatment begins, the functional status is again measured to see if the patient is improving. Notes: - administered by a health care provider - includes question about suicidal ideation - asks about sleep & appetite thus is influenced by comorbities [3] - can be used to assess treatment efficacy [3]

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patient health questionniare (PHQ)

References

  1. PHQ-9 http://www.americangeriatrics.org/education/dep_tool_05.pdf
  2. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. PMID: 11556941
  3. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  4. Levis B, Benedetti A, Thombs BD et al. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: Individual participant data meta-analysis. BMJ 2019 Apr 9; 365:l1476 PMID: 30967483 Free Article https://www.bmj.com/content/365/bmj.l1476
  5. Zimmerman M Using the 9-Item Patient Health Questionnaire to Screen for and Monitor Depression. JAMA. Published online October 18, 2019 PMID: 31626276 https://jamanetwork.com/journals/jama/fullarticle/2753532
  6. NEJM Knowledge+ Psychiatry
  7. PHQ-9 (Patient Health Questionnaire-9) https://www.mdcalc.com/phq-9-patient-health-questionnaire-9