Are you saying that pcps should give depression diagnosis on basis of phq9 alone so we can accurately count positive screening. Phq9 scores can be used to plan and monitor treatment. The patient health questionnaire phq9 overview the phq9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. The screening process starts with the patient health questionnaire phq 9, a wellknown and valid tool. The goal of acute phase treatment is remission of symptoms as indicated by a phq9 score of. Measures of depression and depressive symptoms beck depression inventoryii bdiii, center for epidemiologic studies depression scale cesd, geriatric depression scale gds, hospital anxiety and depression scale hads, and patient health questionnaire9 phq9 karen l. The phq9 is the nine item depression scale of the patient health questionnaire1. Getting paid for screening and assessment services fpm. Assessment of depression severity with the phq9 in cancer. People with persistent symptoms after 23 months need active treatment.
Reprinted with permission from kroenke k, spitzer rl, williams jb, lowe b. The 12month incidence and predictors of phq9screened depressive symptoms in chinese primary care patients. Understanding and implementing uds measures for depression. The phq 2 and 9 are quick and easy to administer 1,2. Scoring the phq 9 modified for teens scoring the phq 9 modified for teens is easy but involves thinking about several different aspects of depression. Accuracy of patient health questionnaire9 phq9 for. Pcps should give depression diagnosis on basis of phq9 alone so.
The patient health questionnaire phq9 is a widely used instrument to screen for depression in clinical research. Brief description selfadministered 9item instrument based on the nine dsmv criteria listed under criterion a for major depressive disorder. The aim of this study was to assess the validity of the patient health questionnaire depression module phq 9. This is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of not at all. Utilization of the phq 9 to monitor depression symptoms for. Since this scale is selfadministered in our studies, question. The index date is defined as the first phq9 score greater than 9 between 12120 to 12014. Major depression is a serious mental illness affecting millions of adults. See guide to selfmanagement and selfcare action plan.
If this is positive, the phq 9 can then be used, which has 61% sensitivity and 94% specificity in adults. The phq 9 should not be used to make a definitive diagnosis of depression. An ultrabrief screening scale for anxiety and depression. The results of the phq9 may be used to make a depression diagnosis according to dsmiv criteria and takes less than 3 minutes to complete.
The phq 9 was developed for use in primary care settings. People on watchful waiting benefit from selfcare activities. It is the 9 question depression scale from the patient health questionnaire phq. Time frames based on in recent large scale implementations 14.
Patient health questionnaire phq9 british columbia. Comparison of two selfrating scales to detect depression. Phq9 as their depression screening tool, and others choose to begin with the phq2 as a prescreen to determine whether to move forward with the full phq9. Guideline for using the phq9 for initial management score symptom level treatment1 04 no depression consider other diagnoses 59 minimal consider other diagnoses if diagnosis is depression, watchful waiting2 is appropriate initial management. Patient health questionnaire phq9 for depression using phq9 diagnosis and score for initial treatment selection a depression diagnosis that warrants treatment or treatment change, needs at least one of the first two questions endorsed as. The phq 9 is intended as a tool to assist clinicians with identifying and diagnosing depression but is not a substitute for diagnosis by a. Depression hedis metrics that matter and how they impact practice. The phq9 is a nineitem selfreport depression scale that guides the clinician. When screening for depression the patient health questionnaire phq2 can be used first it has a 97% sensitivity and a 67% specificity.
Studies have verified that the phq 9 accurately identifies the presence of depression, as well as measures the severity of depression. The phq 9 is a nineitem selfreport depression scale that. Objective to determine the accuracy of the patient health questionnaire 9 phq 9 for screening to detect major depression. Consider screening at least once during pregnancy and again four to eight weeks after delivery. Instructions for patient health questionnaire phq and gad7 measures. Major depression is a serious mental illness affecting millions of adults and children each year with impacts on health outcomes, quality of life, and cost of care. The phq 2 is a tool used to screen for depression, while the phq 9 tool is used to screen or diagnose depression, measure the severity of symptoms, and measure a patients response to treatment. Physician uses clinical judgment about treatment, based on patients duration of symptoms and functional impairment. A score of 10 or greater is considered major depression, 20 or more is severe major depression. It has usefulness as a screening tool for situations where depression is suspected, and as an. Patient completes phq9 quick depression assessment. Phq29 scores and action plans accountable health partners. It is one of the most validated tools in mental health and can be a powerful tool to assist clinicians with diagnosing depression and monitoring treatment response.
Multiply that number by the value indicated below, then add the subtotal to produce a total score. Spanish personal health questionnaire depression scale phq8. Patients rate how they have been doing in each area using a 0 to 3 scale. Depression hedis metrics that matter and how they impact. Major depression is a serious mental illness affecting millions of adults and children each year with. If the phq 9 proves sensitive to change in clinical trials, it could also be a useful measure for monitoring outcomes of depression therapy.
Inclusion criteria eligible studies compared phq 9 scores with major depression diagnoses. The 12month incidence and predictors of phq9screened. Responders are asked to rate the frequency of depression symptoms in the last 2 weeks on a likert. Questions 1 andor 2 need to be endorsed as a 2 or 3. Brevity coupled with its construct and criterion validity makes the phq9 an attractive, dualpurpose instrument for making diagnoses and assessing severity of depressive disorders. If this is positive, the phq9 can then be used, which has 61% sensitivity and 94% specificity in adults. Screening for depression and followup plan careoregon. Understanding and implementing uds measures for depression screening, documentation, and practice. Depression screening by a nineitem patient health questionnaire phq 9 in adults formulary drug information for this topic no drug references linked in this topic.
Research has shown that certain scores on the phq9 are strongly correlated with a subsequent diagnosis of major depression although not everyone with an elevated phq9 is certain to have major depression. Phq9 depression scale university of washington aims center. Phq9 questionnaire for depression scoring and interpretation guide for physician use only scoring. Multiple research studies have evaluated the reliability consistency and validity accuracy of the phq9. Patient health questionnaire phq 9 for depression using phq 9 diagnosis and score for initial treatment selection a depression diagnosis that warrants treatment or treatment change, needs at least one of the first two questions endorsed as positive little pleasure, feeling depressed indicating the. Screening for clinical depression and followup plan. In total, the phq 9 scale identified 30% more patients as depressed compared to the hadsd scale. Studies have verified that the phq9 accurately identifies the presence of depression, as well as measures the severity of depression.
Using the patient health questionnaire phq9 and the. Sep 01, 2009 as seen in table 2, the phq 9 scale diagnosed more than twice as many patients with severe depression in comparison with the hadsd scale, while the two scales identified equal amounts of mild forms of depression. Phq9 patient health questionnaire pdf often used as a followup to a phq2 for those with a score of 2 or higher edinburgh postnatal depression scale epds postpartum depression screening scale pdss women with a positive screening assessment require followup evaluation and potentially treatment. Guide for interpreting phq9 scores score action 04 the score suggests the patient may not need depression treatment 514 mild major depressive disorder. The patient health questionnaire 9 phq9 is one of the tools used to screen for the presence and severity of depression and to monitor response to treatment.
It has been subject to studies in medical settings, but its validity as a screening for depression in the general population is unknown. Remission is defined as a phq9 score less than five. Depression toolkit patient health questionnaire phq9 adolescent. The aim of this study was to assess the validity of the patient health questionnaire depression module phq9. The phq9 is a nineitem selfreport depression scale that. All patients aged 12 and older with at least one eligible encounter during the year. The patient health questionnaire phq 9 is a brief, 9 item selfreport screening tool that may help identify symptoms that could relate to depression. In our study, this questionnaire assesseed 9 depressive symptoms experienced by participants in the 14 days prior to evaluation. The phq9 is a 9question instrument given to patients in a primary care setting to screen for the presence and severity of depression. Patient health questionnaire 9 phq9 health navigator nz. The screening process starts with the patient health questionnaire phq9, a wellknown and valid tool. Request pdf on mar 1, 2016, helen sawaya and others published adaptation and initial validation of the patient health questionnaire 9 phq9 and the generalized anxiety disorder 7. The results have repeatedly demonstrated that the phq 9 is an effective way to measure depression.
Phq9 patient depression questionnaire instructions for initial diagnosis 1. Guideline for using the phq 9 for initial management score symptom level treatment1 04 no depression consider other diagnoses 5 9 minimal consider other diagnoses if diagnosis is depression, watchful waiting2 is appropriate. For instance, aetna has a longstanding policy to cover depression screening in primary care when the service is performed using the patient health questionnaire 9 phq 9 tool and is reported. Phq 9 patient depression questionnaire for initial diagnosis. Each item was rated on the frequency of a depressive symptom. Phq 9 and major depression major depression is diagnosed if 5 or more of the 9 depressive symptom criteria have been present at least more than half the. Treatment plan, considering counseling, followup andor. Inclusion criteria eligible studies compared phq9 scores with major depression.
Scores on the phq2 can range from 0 to 6, and a cutoff score. The phq 9 dep 9 in some sourcesis a 9 question instrument given to patients in a primary care setting to screen for the presence and severity of depression. To use the phq 9 as a diagnostic aid for major depressive disorder. Phq 9 questionnaire for depression scoring and interpretation guide for physician use only scoring. Depression screening agency for health research and quality. Research has shown that certain scores on the phq 9 are strongly correlated with a subsequent diagnosis of major depression although not everyone with an elevated phq 9 is certain to have major depression. A number of studies have used this scale for adolescent patients. Depression should not be diagnosed or excluded solely on the basis of a phq 9 score. The main section has nine items, corresponding to the nine diagnostic symptoms for major depressive disorder in the dsm5. For instance, aetna has a longstanding policy to cover depression screening in primary care when the service is performed using the patient health questionnaire9 phq9 tool and is reported. The phq9 should not be used to make a definitive diagnosis of depression. Depression hedis metrics that matter and how they impact practice anne shields rn, mha associate director, aims center. Spanish personal health questionnaire depression scale.
Data sources medline, medline inprocess and other nonindexed citations, psycinfo, and web of science january 2000february 2015. Is a positive score on the phq2 or the phq9 enough to diagnose depression. Phq9 assessment resources developed by the visn 4 mirecc. Depression screening by a nineitem patient health questionnaire phq9 in adults formulary drug information for this topic no drug references linked in this topic. It is based directly on the it is based directly on the diagnostic criteria for major depressive disorders in diagnostic and statistical manual fourth edition dsmiv 2. Adaptation and initial validation of the patient health. The phq 9 is the nine item depression scale of the patient health questionnaire1. The phq9 is intended as a tool to assist clinicians with identifying and diagnosing depression but is not a substitute for diagnosis by a. Role of the phq9 mark williams, md miccsi webinar february 2014. The phq9 is a nineitem selfreport depression scale that guides the clinician in. When screening for depression the patient health questionnaire phq 2 can be used first it has a 97% sensitivity and a 67% specificity. If the phq9 proves sensitive to change in clinical trials, it could also be a useful measure for monitoring outcomes of depression therapy. What does the phq 9 score mean for treatment planning. As seen in table 2, the phq9 scale diagnosed more than twice as many patients with severe depression in comparison with the hadsd scale, while the two scales identified equal amounts of mild forms of depression.
Scores are rated as normal 02, mild 35, moderate 68, and severe 912. Phq9 no longer counts as followup to a positive phq2 screening. Phq9 scoring card for severity determination instructions for use for doctor or healthcare professional use only phq9 quick depression assessment for initial diagnosis. The patient health questionnaire phq 9 the phq 9 is a 9 item, depression screening scale kroenke et al. Utilization of the phq 9 to monitor depression symptoms for adolescents and adults 2. Multiple research studies have evaluated the reliability consistency and validity accuracy of the phq 9. Patient completes phq 9 quick depression assessment. The phq 9 is a nineitem selfreport depression scale that guides the clinician. The clinician and support staff monitor compliance with the plan and improvements in. The first aim of this study was to psychometrically test the phq9 in a large sample of cancer patients. The patient health questionnaire, or phq9, seems like a good option, and it is one of the most widelyused screening tools in clinical practice. The phq9 dep9 in some sourcesis a 9question instrument given to patients in a primary care setting to screen for the presence and severity of depression. The instrument aids in guiding criteria based diagnosis of depressive symptoms, can assist in identifying treatment goals, determining severity of symptoms, as well as.
The results have repeatedly demonstrated that the phq9 is an effective way to measure depression. Pdf the psychometric properties of phq4 depression and. The second aim was to calculate unbiased estimates of the depression burden for several cancer groups taking into account age and gender distributions. Phq9 patient depression questionnaire for initial diagnosis. The psychometric properties of phq4 depression and anxiety screening scale among college students article pdf available in archives of psychiatric nursing 304. In total, the phq9 scale identified 30% more patients as depressed compared to the hadsd scale. The phq 9 is the nine item depression scale of the patient health questionnaire.
Brevity coupled with its construct and criterion validity makes the phq 9 an attractive, dualpurpose instrument for making diagnoses and assessing severity of depressive disorders. Characteristics not tested in our studies in spanish. Objective to determine the accuracy of the patient health questionnaire9 phq9 for screening to detect major depression. This is not intended to provide a diagnosis only trained health professionals should do this. The phq 2 is a tool used to screen for depression, while the phq 9 tool is used to.
645 1526 455 651 48 1035 1360 1264 1608 1491 629 1532 489 868 600 1328 41 1521 1540 1350 957 1376 1485 1470 882 408 1329 317 1563 1118 585 436 1213 932 563 1326 1397 218 145 943 853 715 616 718 292 840