Relationship Between PHQ-2 and PHQ-9 in Detecting Depression in Adolescents

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Submission ID :
ESPR118
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Abstract: :

Background: There has been a significant increase in depression among adolescents over the past decade, with an estimated 20% of adolescents experiencing a major depressive disorder (MDD) by the time they reach 18 years of age. Early detection is important because of the potential chronic nature of depression and its numerous sequelae such as impaired social functioning, increased risk for suicidality and higher rates of depression well into adulthood. The 2-item and 9-item Patient Health Questionnaires (PHQ-2 and PHQ-9, respectively) are validated screening tools for depression in individuals 12 years of age and older. The PHQ-2 is used for screening while the PHQ-9 may be used to screen, diagnose, measure severity of symptoms and monitor response to intervention. Some studies found that while the PHQ-2 performed well, the PHQ-9 was superior in detecting depression and was further recommended as a depression screening instrument to improve detection. Other studies have also compared the PHQ-2 and PHQ-9 among adults in the primary care setting; however, there are no recent studies that compare the performance of the two tests in an urban adolescent population.  

 

Objectives: To compare the PHQ-2 with the PHQ-9 in detecting depression in an urban adolescent population.

 

Design/Methods: Cross-sectional study of adolescent subjects 12-18 years of age. All subjects completed the PHQ-2 and PHQ-9 questionnaires. Demographic data included age, gender, and ethnicity. Statistical analysis focused on the relationship between the two validated instruments in detecting depression. 

 

Results: One hundred and forty-two subjects were included in the study. Participants were predominantly Hispanic (73.9%) and more than half were female (52.1%). Most of the subjects were mid to late adolescents, age 15-18 years. There was a significant difference in the over-all scores of both PHQ-2 and PHQ-9 in females compared with males (P=0.00 and 0.001, respectively), with females scoring higher on both screening tools. On the PHQ-2, males scored an average of 0.6±92 and females scored an average of 1.31±1.57. On the PHQ-9, the average score among males was 2.74±3.21 and for females was 5.14±4.92. There was a high correlation between the two tests in detecting depression (P=<0.01) with cut-off points set at 3 for the PHQ-2 and 10 for the PHQ-9. There was no significant difference found between the two tests in relation to age or ethnicity. 

 

Conclusion: These data suggest that the PHQ-2 and PHQ-9 depression screening questionnaires are effective screening tools in detecting depression among urban adolescents.  Because adolescent girls scored higher for depression on both screening tools, future studies should investigate the use of different cut-offs for the detection of depression in males and females completing the PHQ-2 and PHQ-9.


St. Barnabas Hospital
St. Barnabas Hospital, Bronx, NY
St. Barnabas Hospital

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