<p>The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD tool for common mental health disorders administered by health care professionals. The PHQ-2 inquires about the frequency of depressed mood, with a score ranging from 0 to 6. The authors identify a cut-off score of 3 as the optimal cut point for screening purposes, and stated that a cut point of 2 would enhance sensitivity.</p>
<p>The PHQ-2, comprising the first 2 items of the PHQ-9, inquires about the degree to which an individual has experienced depressed mood and anhedonia over the past two weeks. Its purpose is not to establish final diagnosis or to monitor depression severity, but rather to screen for depression. Patients who screen positive should be further evaluated with the PHQ-9 to determine whether they meet criteria for a depressive disorder. The PHQ-2 has been validated in 3 studies in which it showed wide variability in sensitivity (Gilbody, Richards, Brealey, and Hweitt, 2007).</p>
<p>Developed by Drs. R.L. Spitzer, J.B.W. Williams, K. Kroenke and colleagues, with an educational grant from Pfizer, Inc. No permission required to reproduce, translate, display or distribute.</p>
Registration Status:
Qualified
Designations:
Designation:
Patient Health Questionnaire-2 (PHQ-2)
Tags:
Health
Designations:
Definition:
<p>The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD tool for common mental health disorders administered by health care professionals. The PHQ-2 inquires about the frequency of depressed mood, with a score ranging from 0 to 6. The authors identify a cut-off score of 3 as the optimal cut point for screening purposes, and stated that a cut point of 2 would enhance sensitivity.</p>
<p>The PHQ-2, comprising the first 2 items of the PHQ-9, inquires about the degree to which an individual has experienced depressed mood and anhedonia over the past two weeks. Its purpose is not to establish final diagnosis or to monitor depression severity, but rather to screen for depression. Patients who screen positive should be further evaluated with the PHQ-9 to determine whether they meet criteria for a depressive disorder. The PHQ-2 has been validated in 3 studies in which it showed wide variability in sensitivity (Gilbody, Richards, Brealey, and Hweitt, 2007).</p>
<p>Developed by Drs. R.L. Spitzer, J.B.W. Williams, K. Kroenke and colleagues, with an educational grant from Pfizer, Inc. No permission required to reproduce, translate, display or distribute.</p>
Tags:
Health
Reference Documents:
ID:
PatientHealthQuestionnaire-2_v1.0_2014Jul2.pdf
Title:
NIDA Clinical Trials Network - Patient Health Questionnaire-2 (PHQ-2)
The Patient Health Questionnaire-2: validity of a two-item depression screener. (Kroenke K, Spitzer RL, Williams JB.)
URI:
http://www.ncbi.nlm.nih.gov/pubmed/14583691
Provider Org:
Regenstrief Institute for Health Care and Department of Medicine, Indiana University, Indianapolis, Indiana 46202, USA. kkroenke@regenstrief.org
Language Code:
US
Document:
BACKGROUND:
A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2.
METHODS:
The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.
RESULTS:
As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples.
CONCLUSION:
The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.
ID:
Title:
Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. (Spitzer RL, Kroenke K, Williams JB.)
URI:
http://www.ncbi.nlm.nih.gov/pubmed/10568646
Provider Org:
Biometrics Research Department, New York State Psychiatric Institute, and Columbia University, New York 10032, USA. rls8@columbia.edu
Language Code:
US
Document:
CONTEXT:
The Primary Care Evaluation of Mental Disorders (PRIME-MD) was developed as a screening instrument but its administration time has limited its clinical usefulness.
OBJECTIVE:
To determine if the self-administered PRIME-MD Patient Health Questionnaire (PHQ) has validity and utility for diagnosing mental disorders in primary care comparable to the original clinician-administered PRIME-MD.
DESIGN:
Criterion standard study undertaken between May 1997 and November 1998.
SETTING:
Eight primary care clinics in the United States.
PARTICIPANTS:
Of a total of 3000 adult patients (selected by site-specific methods to avoid sampling bias) assessed by 62 primary care physicians (21 general internal medicine, 41 family practice), 585 patients had an interview with a mental health professional within 48 hours of completing the PHQ.
MAIN OUTCOME MEASURES:
Patient Health Questionnaire diagnoses compared with independent diagnoses made by mental health professionals; functional status measures; disability days; health care use; and treatment/referral decisions.
RESULTS:
A total of 825 (28%) of the 3000 individuals and 170 (29%) of the 585 had a PHQ diagnosis. There was good agreement between PHQ diagnoses and those of independent mental health professionals (for the diagnosis of any 1 or more PHQ disorder, kappa = 0.65; overall accuracy, 85%; sensitivity, 75%; specificity, 90%), similar to the original PRIME-MD. Patients with PHQ diagnoses had more functional impairment, disability days, and health care use than did patients without PHQ diagnoses (for all group main effects, P<.001). The average time required of the physician to review the PHQ was far less than to administer the original PRIME-MD (<3 minutes for 85% vs 16% of the cases). Although 80% of the physicians reported that routine use of the PHQ would be useful, new management actions were initiated or planned for only 117 (32%) of the 363 patients with 1 or more PHQ diagnoses not previously recognized.
CONCLUSION:
Our study suggests that the PHQ has diagnostic validity comparable to the original clinician-administered PRIME-MD, and is more efficient to use.