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BMC Health Serv Res. 2010 Aug 12;10:235. doi: 10.1186/1472-6963-10-235.

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

Author information

1
Department of Diagnostics and Treatment of Common Mental Disorders, Trimbos-Institute, PO Box 725, 3500 AS Utrecht, the Netherlands. Ksteenbergen@trimbos.nl

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.

PMID:
20704720
PMCID:
PMC2927590
DOI:
10.1186/1472-6963-10-235
[Indexed for MEDLINE]
Free PMC Article

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