scholarly journals Comparison of PHQ-9 and PHQ-2 as Screening Tools for Depression and School Related Stress in Inner City Adolescents

2021 ◽  
Vol 12 ◽  
pp. 215013272110537
Author(s):  
Paridhi Anand ◽  
Navpreet Bhurji ◽  
Nadia Williams ◽  
Ninad Desai

Background Major depressive disorder is associated with significant morbidity and mortality in adolescents. Suicide is one of the leading causes of mortality between 15 and 19 years. Both AAP and USPSTF recommend routine depression screening of adolescents. Patient Health Questionnaire-2 (PHQ-2) and Patient Health Questionnaire-9 (PHQ-9) are widely used in primary care practice, however, PHQ-2 does not screen for suicidality. School-related factors are known to affect adolescent mental health. Purpose To compare PHQ-2 and PHQ-9 for depression screening in adolescents, with respect to age, gender, chronic illness over the course of 9 months. Methods As a QI initiative, we compared screening results in our inner-city pediatric practice using PHQ-2 and PHQ-9 from Jun’18 to Feb’19. EMR of 2364 patients 12 to 21 years were reviewed. We considered the PHQ-2 score of ≥2 and PHQ-9 of ≥10 as positive. Pre-existing chronic medical and mental illnesses were noted. Results Of these 61.5% of patients were females, 95% were Black/Hispanic, and 96% were insured by Medicaid. About 10.6% of PHQ-9 tests were positive whereas 7.4% PHQ2 were positive. Logistic regression was performed to ascertain the effects of age, gender, and chronic illness. Females were more likely to have a positive screen, as were patients with chronic illness. Age had no effect on the outcome. The screening yield for both tests was comparable in the summer months. PHQ9 yield increased while schools were in session while PHQ 2 remained stable. Conclusion PHQ9 is superior as a screening test compared to PHQ2. Repeat screening should be targeted toward patients with chronic medical conditions and/or mental health diagnoses. PHQ9 may be better at screening for school-related stress.

2019 ◽  
Vol 63 (15-16) ◽  
pp. 2572-2585 ◽  
Author(s):  
Ben J. Riley ◽  
David Smith ◽  
Michael F. Baigent

The rate of females imprisoned worldwide has increased by more than 50% during the last two decades, with recent figures suggesting that, worldwide, the female prison population may still be increasing at a faster rate than males. Despite prevalence rates for psychiatric conditions among female prisoners being significantly higher than males, there is a particular lack of programs specifically designed for women. This preliminary study evaluates the initial effectiveness of a mindfulness and acceptance–based group program in an uncontrolled pragmatic pilot study of a heterogeneous group of incarcerated women with a range of mental health issues. Participants were 59 incarcerated women who engaged in a 10-session group program. Outcome measures comprised the Acceptance and Action Questionnaire–II, Depression Anxiety and Stress Scale, Mindfulness Attention Awareness Scale, and three screening tools derived from the full version of the Patient Health Questionnaire (PHQ-9), to measure depression, binge eating (Patient Health Questionnaire–Binge Eating Disorder [PHQ-ED]), and somatoform disorders (PHQ-15). Results of linear mixed modelling showed improvements in mindfulness and acceptance, and reductions in depression, anxiety, and somatoform symptoms. Furthermore, acceptance and commitment therapy (ACT) was shown to be an acceptable and feasible intervention for female Indigenous Australian prisoners. A mindfulness and acceptance–based group approach appears to be feasible and acceptable in a prison environment for a female prisoners with a range of mental health symptomatology.


2020 ◽  
Vol 40 (12) ◽  
pp. 1373-1380 ◽  
Author(s):  
Emily A Spataro ◽  
Cherian K Kandathil ◽  
Mikhail Saltychev ◽  
Cristen E Olds ◽  
Sam P Most

Abstract Background Identifying mental health disorders, including body dysmorphic disorder (BDD), is important prior to rhinoplasty surgery; however, these disorders are underdiagnosed, and screening tools are underutilized in clinical settings. Objectives The authors sought to evaluate the correlation of a rhinoplasty outcomes tool (Standardized Cosmesis and Health Nasal Outcomes Survey [SCHNOS]) with psychiatric screening tools. Methods Patients presenting for rhinoplasty consultation were prospectively enrolled and administered mental health instruments to assess depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and BDD (BDD Questionnaire-Aesthetic Surgery [BDDQ-AS]) as well as the SCHNOS rhinoplasty outcomes scale. Convergent validity of SCHNOS scores with these mental health instruments was assessed as well as calculation of an optimal SCHNOS-C score to screen for BDD. Results A total 76 patients were enrolled in the study. The average SCHNOS-O score (standard deviation) was 46.1 (34.0) and the average SCHNOS-C score was 61.1 (27.0). Five (7%) patients screened positive for depression, and 24 (32%) patients screened positive for mild, 5 (7%) for moderate, and 4 (5%) for severe anxiety. Twenty-four (32%) patients screened positive for BDD by BDDQ-AS scores. SCHNOS-O and SCHNOS-C did not correlate with Patient Health Questionnaire-9 or Generalized Anxiety Disorder-7 scores; SCHNOS-C did correlate with BDDQ-AS. A score of 73 or greater on SCHNOS-C maximized the sensitivity and specificity of also screening positive for BDD with BDDQ-AS. This score correlated with a sensitivity of 62.5%, specificity of 80.8%, and number needed to diagnose of 2.3, meaning for every 2 patients with a score of ≥73 on SCHNOS-C, 1 will have a positive BDDQ-AS score. Conclusions SCHNOS-C correlates with BDDQ-AS and may help screen rhinoplasty patients at higher risk for BDD. Level of Evidence: 2


2020 ◽  
Vol 15 (12) ◽  
pp. 1785-1795
Author(s):  
Karli Kondo ◽  
Jennifer R. Antick ◽  
Chelsea K. Ayers ◽  
Devan Kansagara ◽  
Pavan Chopra

Background and objectivesPatients with kidney failure experience depression at rates higher than the general population. Despite the Centers for Medicare and Medicaid Services’ ESRD Quality Incentive Program requirements for routine depression screening for patients with kidney failure, no clear guidance exists.Design, setting, participants, & measurementsFor this systematic review, we searched MEDLINE, PsycINFO, and other databases from inception to June 2020. Two investigators screened all abstracts and full text. We included studies assessing patients with kidney failure and compared a tool to a clinical interview or another validated tool (e.g., Beck Depression Inventory II). We abstracted data related to sensitivity and specificity, positive and negative predictive value, and the area under the curve. We evaluated the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2.ResultsA total of 16 studies evaluated the performance characteristics of depression assessment tools for patients with kidney failure. The Beck Depression Inventory II was by far the best studied. A wide range of thresholds were reported. Shorter tools in the public domain such as the Patient Health Questionnaire 9 and Geriatric Depression Scale 15 (adults over 60) performed well but were not well studied. Short tools such as the Beck Depression Inventory–Fast Screen may be a good option for an initial screen.ConclusionsThere is limited research evaluating the diagnostic accuracy of most screening tools for depression in patients with kidney failure, and existing studies may not be generalizable to US populations. Studies suffer from limitations related to methodology quality and/or reporting. Future research should target widely used, free tools such as the Patient Health Questionnaire 2 and the Patient Health Questionnaire 9.Clinical Trial registry name and registration number:Systematic Review Registration: PROSPERO CRD42020140227.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jung Hyun Lee ◽  
Dayoung Lee ◽  
Soyoen Hyun ◽  
Ji Sun Hong ◽  
Chang-Hoon Kim ◽  
...  

Experiences of infectious diseases cause stressful and traumatic life events, hence, coronavirus disease 2019 (COVID-19) patients could suffer from various mental health problems requiring psychological support services. This study investigates the severity of mental health problems among confirmed COVID-19 patients. From March to November 2020, we collected the data from 118 COVID-19 patients who voluntarily participated in the National Center for Disaster Trauma's online mental health assessment consisting of self-report scales like Primary Care of Posttraumatic Stress Disorder screen (PC-PTSD), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and P4 Suicidality Screener. For control, 116 other disaster-experienced and 386 non-COVID-19-experienced participants were recruited. The COVID-19 patients showed more severe symptoms including post-traumatic symptoms, depression, anxiety, and somatic symptoms than control groups across all four screening scales (p < 0.001). Regarding high-risk, COVID-19 patients had an increased association with high-risk compared to the comparison groups (PC-PTSD: OR = 24.16, 95% CI = 13.52–43.16 p < 0.001; PHQ-9: OR = 14.45, 95% CI = 8.29–25.19, p < 0.001; GAD-7: OR=20.71, 95% CI = 10.74–39.96, p < 0.001; PHQ-15: OR = 5.65, 95% CI = 3.44–9.25, p < 0.001; P4: OR = 14.67, 95% CI = 8.95–25.07, p < 0.001). This study's results imply that there is a high-risk of overall mental health problems, especially stronger associations of post-traumatic stress symptoms, in COVID-19 patients. These findings help inform practitioners about the psychological responses to COVID-19 experiences and to prepare appropriate interventions and services for the incremental number of confirmed cases.


2011 ◽  
Vol 52 (1) ◽  
pp. 96-101 ◽  
Author(s):  
Shen-Ing Liu ◽  
Zai-Ting Yeh ◽  
Hui-Chun Huang ◽  
Fang-Ju Sun ◽  
Jin-Jin Tjung ◽  
...  

2020 ◽  
Vol 47 (04) ◽  
pp. 190-197 ◽  
Author(s):  
Jens Bohlken ◽  
Friederike Schömig ◽  
Matthias R. Lemke ◽  
Matthias Pumberger ◽  
Steffi G. Riedel-Heller

Zusammenfassung Ziel Darstellung von Studien zur psychischen Belastung von medizinischem Personal unter Bedingungen der COVID-19-Pandemie. Methodik PubMed-gestützte Suche mit den Stichworten COVID 19“, „stress“, „mental health“, „healthcare worker“, „staff“, „psychiatry“. Eingeschlossen wurden quantitative Studien, (inkl. „Letter to the editor“) zur Belastung des medizinischen Personals im Zeitraum von Januar bis März 2020. Ergebnisse Es wurden 14 Studien mit Klinikpersonal aus Infektionsabteilungen, Abteilungen für Fieberkranke, Abteilungen der Inneren Medizin inklusive Intensivstationen sowie der Chirurgie und Psychiatrie identifiziert. Am häufigsten wurden der Patient Health Questionnaire-9 (PHQ-9), die Self-rating-Anxiety Scale (SAS) und die Impact of Event Scale (IES-R) verwendet. Die Stichprobengröße schwankte zwischen 37 und 1257 Personen des überwiegend pflegerischen und ärztlichen Personals. Der Anteil an COVID-19-nahen Tätigkeiten schwankte zwischen 7,5 % und 100 %. Es wurde eine erhebliche Belastung durch Stresserleben, depressive und ängstliche Symptome berichtet. Schwere Ausprägungsgrade fanden sich bei 2,2–14,5 % der Befragten. Die Ausprägung der psychischen Symptomatik wurde beeinflusst durch Alter, Geschlecht, Berufsgruppe, Fachrichtung, Art der Tätigkeit und die Nähe zu COVID-19-Patienten. Als Mediatorvariablen wurden das Personalmanagement, die präventive Intervention, die Resilienz und vorhandene soziale Unterstützung angesehen. Schlussfolgerung Angesichts der Häufigkeit psychischer Symptome bei medizinischem Personal erscheinen begleitende psychiatrisch-psychotherapeutisch informierte Interventionen notwendig, um eine Bewältigung zu unterstützen. Eine schnell einsetzende Forschung ist in diesem Bereich wünschenswert.


2013 ◽  
Vol 22 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Anthony W. McGuire ◽  
Jo-Ann Eastwood ◽  
Aurelia Macabasco-O'Connell ◽  
Ron D. Hays ◽  
Lynn V. Doering

BackgroundDepression screening in cardiac patients has been recommended by the American Heart Association, but the best approach remains unclear.ObjectivesTo evaluate nurse-administered versions of the Patient Health Questionnaire for depression screening in patients hospitalized for acute coronary syndrome.MethodsStaff nurses in an urban cardiac care unit administered versions 2, 9, and 10 of the questionnaire to 100 patients with acute coronary syndrome. The Depression Interview and Structured Hamilton was administered by advanced practice nurses blinded to the results of the Patient Health Questionnaire. With the results of the Depression Interview and Structured Hamilton as a criterion, receiver operating characteristic analyses were done for each version of the Patient Health Questionnaire. The Delong method was used for pairwise comparisons. Cutoff scores balancing false-negatives and false-positives were determined by using the Youden Index.ResultsEach version of the questionnaire had excellent area-under- the-curve statistics: 91.2%, 92.6%, and 93.4% for versions 2, 9, and 10, respectively. Differences among the 3 versions were not significant. Each version yielded higher symptom scores in depressed patients than in nondepressed patients: version 2 scores, 3.4 vs 0.6, P = .001; version 9 scores, 13 vs 3.4, P < .001; and version 10 scores, 14.5 vs 3.6, P < .001.ConclusionsFor depression screening in hospitalized patients with acute coronary syndrome, the Patient Health Questionnaire 2 is as accurate as longer versions when administered by nurses. Further study is needed to determine if screening with this tool changes clinical decision making or improves outcomes in these patients.


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