Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics.

Abstract:

BACKGROUND:For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9). The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument for depression in diabetes patients in outpatient clinics. METHODS:197 diabetes patients from outpatient clinics in the Netherlands filled in the PHQ-9. Within 2 weeks they were approached for an interview with the Mini Neuropsychiatric Interview. DSM-IV diagnoses of Major Depressive Disorder (MDD) were the criterion for which the sensitivity, specificity, positive- and negative predictive values and Receiver Operator Curves (ROC) for the PHQ-9 were calculated. RESULTS:The cut-off point of a summed score of 12 on the PHQ-9 resulted in a sensitivity of 75.7% and a specificity of 80.0%. Predictive values for negative and positive test results were respectively 93.4% and 46.7%. The ROC showed an area under the curve of 0.77. CONCLUSIONS:The PHQ-9 proved to be an efficient and well-received screening instrument for MDD in this sample of diabetes patients in a specialized outpatient clinic. The higher cut-off point of 12 that was needed and somewhat lower sensitivity than had been reported elsewhere may be due to the fact that the patients from a specialized diabetes clinic have more severe pathology and more complications, which could be recognized by the PHQ-9 as depression symptoms, while instead being diabetes symptoms.

journal_name

BMC Health Serv Res

authors

van Steenbergen-Weijenburg KM,de Vroege L,Ploeger RR,Brals JW,Vloedbeld MG,Veneman TF,Hakkaart-van Roijen L,Rutten FF,Beekman AT,van der Feltz-Cornelis CM

doi

10.1186/1472-6963-10-235

subject

Has Abstract

pub_date

2010-08-12 00:00:00

pages

235

issn

1472-6963

pii

1472-6963-10-235

journal_volume

10

pub_type

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