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

• Main Authors: van Steenbergen-Weijenburg Kirsten M (Author), de Vroege Lars (Author), Ploeger Robert R (Author), Brals Jan W (Author), Vloedbeld Martijn G (Author), Veneman Thiemo F (Author), Hakkaart-van Roijen Leona (Author), Rutten Frans FH (Author), Beekman Aartjan TF (Author), van der Feltz-Cornelis Christina M (Author)
• Format: Book
• Published: BMC, 2010-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<p>Abstract</p> <p>Background</p> <p>For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9). The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument for depression in diabetes patients in outpatient clinics.</p> <p>Methods</p> <p>197 diabetes patients from outpatient clinics in the Netherlands filled in the PHQ-9. Within 2 weeks they were approached for an interview with the Mini Neuropsychiatric Interview. DSM-IV diagnoses of Major Depressive Disorder (MDD) were the criterion for which the sensitivity, specificity, positive- and negative predictive values and Receiver Operator Curves (ROC) for the PHQ-9 were calculated.</p> <p>Results</p> <p>The cut-off point of a summed score of 12 on the PHQ-9 resulted in a sensitivity of 75.7% and a specificity of 80.0%. Predictive values for negative and positive test results were respectively 93.4% and 46.7%. The ROC showed an area under the curve of 0.77.</p> <p>Conclusions</p> <p>The PHQ-9 proved to be an efficient and well-received screening instrument for MDD in this sample of diabetes patients in a specialized outpatient clinic. The higher cut-off point of 12 that was needed and somewhat lower sensitivity than had been reported elsewhere may be due to the fact that the patients from a specialized diabetes clinic have more severe pathology and more complications, which could be recognized by the PHQ-9 as depression symptoms, while instead being diabetes symptoms.</p>

Item Description

10.1186/1472-6963-10-235
1472-6963