Cited by 1,354Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingTreatment of Major Depression

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Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9

L??we, Bernd, Un??tzer, J??rgen, Callahan, Christopher M., Perkins, Anthony J., Kroenke, Kurt·2004·Medical Care

DOI 10.1097/00005650-200412000-00006

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Abstract

BACKGROUND: Although effective treatment of depressed patients requires regular follow-up contacts and symptom monitoring, an efficient method for assessing treatment outcome is lacking. We investigated responsiveness to treatment, reproducibility, and minimal clinically important difference of the Patient Health Questionnaire-9 (PHQ-9), a standard instrument for diagnosing depression in primary care. METHODS: This study included 434 intervention subjects from the IMPACT study, a multisite treatment trial of late-life depression (63% female, mean age 71 years). Changes in PHQ-9 scores over the course of time were evaluated with respect to change scores of the SCL-20 depression scale as well as 2 independent structured diagnostic interviews for depression during a 6-month period. Test-retest reliability and minimal clinically important difference were assessed in 2 subgroups of patients who completed the PHQ-9 twice exactly 7 days apart. RESULTS: The PHQ-9 responsiveness as measured by effect size was significantly greater than the SCL-20 at 3 months (-1.3 versus -0.9) and equivalent at 6 months (-1.3 versus -1.2). With respect to structured diagnostic interviews, both the PHQ-9 and the SCL-20 change scores accurately discriminated patients with persistent major depression, partial remission, and full remission. Test-retest reliability of the PHQ-9 was excellent, and its minimal clinically important difference for individual change, estimated as 2 standard errors of measurement, was 5 points on the 0 to 27 point PHQ-9 scale. CONCLUSIONS: Well-validated as a diagnostic measure, the PHQ-9 has now proven to be a responsive and reliable measure of depression treatment outcomes. Its responsiveness to treatment coupled with its brevity makes the PHQ-9 an attractive tool for gauging response to treatment in individual patient care as well as in clinical research.

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Authors: L??we, B., Un??tzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K.
Affiliations: Regenstrief Institute (US)
ORCID: Callahan, Christopher M.
Perkins, Anthony J.
Kroenke, Kurt
Venue: Medical Care
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-12
Volume: 42
Issue: 12
Pages: 1194-1201
ISSN: 0025-7079 (ISSN-L)
DOI: 10.1097/00005650-200412000-00006
OpenAlex: W2049265876
Cited by: 1,354
References: 45
Citations by year: 2026: 89 · 2025: 103 · 2024: 92 · 2023: 101 · 2022: 114 · 2021: 117 · 2020: 84 · 2019: 56 · 2018: 71 · 2017: 54 · 2016: 65 · 2015: 55 · 2014: 60 · 2013: 48 · 2012: 57
FWCI: 27.21
Type: journal article
Language: en
Open access: closed
Locations: Medical Care (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords: PHQ-9, geriatric depression, treatment outcome monitoring, treatment response, test-retest reliability, minimal clinically important difference, remission, primary care depression, impact studies
MeSH terms: Aged, Major Depressive Disorder, Female, Humans, Interview, Psychological, Male, Primary Health Care, Psychiatric Status Rating Scales, Psychometrics, Quality of Life, Surveys and Questionnaires, Outcome Assessment, Health Care, Sickness Impact Profile, Dysthymic Disorder, Self Efficacy, Diagnostic and Statistical Manual of Mental Disorders

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Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9

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