Validation of the PHQ-2 against the PHQ-9 for detecting depression in a large sample of Australian general practice patients
Mariko Carey A B C , Allison Boyes A B , Natasha Noble A B , Amy Waller A B and Kerry Inder A BA Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
B Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, HMRI Building, New Lambton, NSW 2305, Australia.
C Corresponding author. Email: mariko.carey@newcastle.edu.au
Australian Journal of Primary Health 22(3) 262-266 https://doi.org/10.1071/PY14149
Submitted: 10 October 2014 Accepted: 21 January 2015 Published: 26 August 2015
Abstract
There is increasing interest in the use of brief screening tools to improve detection of depression in the primary care setting. The aim of the present study was to compare the accuracy of the two-item Patient Health Questionnaire (PHQ-2) against the nine-item Patient Health Questionnaire (PHQ-9) for detecting depression among general practice patients. A cross-sectional sample of 3626 adults attending 12 Australian general practices was recruited. Participants completed the PHQ-2 and PHQ-9 via a touchscreen computer. Depression was defined as a PHQ-9 score ≥10. The area under the curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value were calculated. The PHQ-2 had good overall accuracy relative to the PHQ-9 for discriminating between cases and non-cases of depression, with an AUC of 0.92 (95% confidence interval 0.90–0.93). The PHQ-2 threshold of ≥3 was the best balance between sensitivity (91%) and specificity (78%) for detecting possible cases of depression. For clinical use, the optimal threshold was ≥2, with only 2% of possible cases missed.
Additional keywords: mental health, primary health care.
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