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Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study.

ABSTRACT: The aim of this study was to examine the sensitivity and specificity of the suicide item on the 9-item Patient Health Questionnaire (PHQ-9) when compared to a structured interview (the Structured Clinical Interview for DSM-IV; SCID-I mood module) in primary care patients with elevated depression symptoms.In this cross-sectional study, we analyzed data from 166 patients from 2 primary care clinics, 1 in Rhode Island and 1 in Massachusetts, who were enrolled in studies that focused on depression in primary care. Of the total participants, 101 were enrolled in the survey study, and 65 were screened for or enrolled in either an open trial or a pilot randomized controlled trial. Data were collected between May 2004 and May 2009.We found that the specificity of the PHQ-9 suicide screening item was 0.84 and sensitivity was 0.69 for the sample as a whole.This study suggests that the routine use of the PHQ-9 may be useful in primary care practice in that it may identify individuals at risk for suicide who would not otherwise have been identified. However, denial of suicidality on the PHQ-9 should be probed further if there are other risk factors for suicide present.clinicaltrials.gov Identifier: NCT00541957.

SUBMITTER: Uebelacker LA

PROVIDER: S-EPMC3121214 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study.

Uebelacker Lisa A LA German Nicole M NM Gaudiano Brandon A BA Miller Ivan W IW

The primary care companion for CNS disorders 20110101 1

<h4>Objective</h4>The aim of this study was to examine the sensitivity and specificity of the suicide item on the 9-item Patient Health Questionnaire (PHQ-9) when compared to a structured interview (the Structured Clinical Interview for DSM-IV; SCID-I mood module) in primary care patients with elevated depression symptoms.<h4>Method</h4>In this cross-sectional study, we analyzed data from 166 patients from 2 primary care clinics, 1 in Rhode Island and 1 in Massachusetts, who were enrolled in stu ...[more]

PMID: 21731830

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Project description:BackgroundWorldwide, the population is ageing, resulting in an associated increase in dementia prevalence. Forgetfulness in elderly people is often perceived as normal in some local cultures and thus, the early detection of dementia in primary care requires detection of symptoms other than memory complaints.This study was conducted to screen elderly patients for early dementia in primary care using a newly developed Early Dementia Questionnaire (EDQ) and comparing it with a standard assessment tool, the Mini Mental State Examination (MMSE).MethodsA cross-sectional study was conducted on a group of elderly patients using convenience sampling of consecutive patients. Elderly depression was excluded using the Geriatric Depression Scale (GDS). Exclusion criteria also included known cases of dementia. Inclusion criteria included a score of 5 or less in GDS and the presence of a reliable informant. A face-to-face interview was done using the EDQ with the patient and informant to elicit symptoms of early dementia. If the informant was not present, a telephone interview was used instead. The patient was then assessed with the Mini Mental State Examination (MMSE) using a cut-off point of 21.ResultsPrevalence of dementia among 155 subjects was 52.3% by EDQ and 15.5% by MMSE. The EDQ demonstrated a sensitivity of 79.2% with specificity of 52.7%. Positive predictive value (PPV) of EDQ was 23.5% with the negative predictive value (NPV) of 93.2%. The strongest predictor of possible early dementia was complaints of memory problems (OR 26.22; 95% CI 2.03-338.14) followed by complaints of concentration problems (OR 14.33; 95% CI 5.53-37.12), emotional problems (OR 4.75; 95% CI 1.64-13.81) and sleep disturbances (OR 3.14; 95% CI 1.15-8.56). Socio-demographic factors, medical problems and smoking status were not associated with possible dementia (p>0.05), despite that 60-70% of the elderly had chronic illnesses.ConclusionThe EDQ is a promising alternative to MMSE for screening of early dementia in primary care.

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Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study.

Publications

Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study.

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