The DOI matches its Crossref record; 44 of the 45 references it cites were found in a registry or an index.
Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The PHQ-9 has demonstrated good sensitivity, specificity, and convergent validity [49,50].”
In the citing paper
“Although the 4-point mean change in PHQ-9 scores was just short of the 5-point recommendation for clinical importance [40], this recommendation is based on a clinically unwell population.”
From A pilot evaluation of a smartphone application for workplace depression (2020) · cites this paper as [40]
In the citing paper
“For participants who were defined as having likely MDD at baseline, the mean change in PHQ-9 score from pre- to post-intervention was over 7 points, reaching the threshold of clinical importance for individual change [40].”
From A pilot evaluation of a smartphone application for workplace depression (2020) · cites this paper as [40]
In the citing paper
“Although the 4-point mean change in PHQ-9 scores was just short of the 5-point recommendation for clinical importance [40], this recommendation is based on a clinically unwell population.”
From A pilot evaluation of a smartphone application for workplace depression (2020) · cites this paper as [40]
In the citing paper
“The PHQ-9 is sensitive to change, has good sensitivity and specificity for detecting depressive disorders, and its psychometric properties are adequate [62, 64, 65].”
In the citing paper
“Several studies support its validity in outpatient adult mental health settings, both as an initial screening tool and as a follow-up measure to monitor treatment progress. 22-25”
From Dialectical behaviour therapy skills training: A feasibility study with active duty military. (2022) · cites this paper as [24]
In the citing paper
“As noted above, we observed clinically meaningful improvements in both anxiety and depression, with reductions in GAD-7 (− 5.04) and PHQ-9 (− 5.64) higher than the MCID for both conditions (3.8 and 5, respectively) [66, 67].”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [67]
Citations
Cites
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910
Self-citationAn inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
(1992) · PubMed · Cited by 33,716
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033
Intraclass correlations: Uses in assessing rater reliability.
Shrout, P. E., & Fleiss, J. L. (1979) · Psychological Bulletin · doi:10.1037/0033-2909.86.2.420 · Cited by 24,532
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392
Spitzer, R. L. (1999) · JAMA · doi:10.1001/jama.282.18.1737 · Cited by 9,802
Jaeschke, R., Singer, J., & Guyatt, G. H. (1989) · Controlled Clinical Trials · doi:10.1016/0197-2456(89)90005-6 · Cited by 4,982
Research works printed but not linked: 3
- Derogatis, 1973, Psychopharmacol Bull, 9, 13
- Simon, 1996, JAMA, 275, 1897, 10.1001/jama.1996.03530480039038 · DOI
- Wells, 2001, J Rheumatol, 28, 406
Cited by
Sorted by citations
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Self-citationThe PHQ-8 as a measure of current depression in the general population
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.026 · Cited by 5,121
Self-citationLöwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008) · Medical Care · doi:10.1097/mlr.0b013e318160d093 · Cited by 4,527
Self-citationKroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.03.006 · Cited by 4,057
Self-citationFreynhagen, R., Baron, R., Gockel, U., & Tölle, T. R. (2006) · Current Medical Research and Opinion · doi:10.1185/030079906x132488 · Cited by 2,280
Metadata
- Authors
- L??we, B., Un??tzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K.
- Affiliations
- Regenstrief Institute (US)
- Venue
- Medical Care
- Published
- 2004-12
- Volume
- 42
- Issue
- 12
- Pages
- 1194-1201
- ISSN
- 0025-7079 (ISSN-L)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
