CoChat
Sign Up
Cited by 39Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and AccessPatient-Provider Communication in Healthcare

Why are there discrepancies between depressed patients’ Global Rating of Change and scores on the Patient Health Questionnaire depression module? A qualitative study of primary care in England

Open access
Robinson, Jude, Khan, Naila, Fusco, Louise, Malpass, Alice, Lewis, Glyn, Dowrick, Christopher·2017·BMJ Open
DOI 10.1136/bmjopen-2016-014519PMC PMC5566896
Open this paper in CoChat — free accountOpen PDF

Abstract

Objectives: Our aims were to investigate discrepancies between depressed patients’ GlobalRating of Change (GRC) and scores on the Patient Health Questionnaire depression module (PHQ-9). Our objectives were to ascertain patients’ views on the source and meaning of mismatches and assess their clinical significance. Design: Qualitative study nested within a cohort, in a programme investigating the indications for prescribing antidepressants that will lead to a clinical benefit. Setting: Primary care practices in north-west England. Participants: We invited 32 adults with a recent diagnosis of depression and evidence of mismatch between GRC and PHQ-9 Scores to participate. Of these, 29 completed our interviews; most were women, identified as white British, had high school education or higher, were employed or retired and had been depressed for a long time. Main measures: We conducted semistructured interviews with a topic guide, focusing on experiences of depression; treatment experiences and expectations; effectiveness of the questionnaires; reasons for the mismatch; and social factors. Interviews were transcribed and subjected to interpretative phenomenological analysis. Results: We identified four themes as explanations for mismatch between GRC and PHQ-9: perceptions that GRC provided a more accurate assessment of current mental state than PHQ-9; impact of recent negative or positive life events on either measure; personal understanding of depression as normally fluctuating, and tendency to underscore on PHQ-9 as a means of self-motivation; and lack of recall. Conclusions: The combined used of the PHQ-9 and a more open question better captures the patient’s unique experiences of mental health. This approach ascertains the relevance of symptoms to the individual’s experience and influences treatment decisions. Study registration: This study was an element of NIHR Programme Grant RP-PG 0610 10048.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1136/bmjopen-2016-014519

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

  • The degrees of agreement and calculations of sensitivity to change in one-item analogical scales are influenced both by the interventions and by events in the patient's life between evaluations.

    “Although therapist-patient agreement is also assumed to be acceptable in this measure, the degrees of agreement and the calculations of sensitivity to change are influenced both by the interventions and by events in the patient's life between evaluations (Hobbs et al., 2021; Price et al., 2022; Robinson et al., 2017).”

    From Patients´ and Therapists´ Reports of Psychotherapy Outcomes: Similarities and Differences (2023) · cites this paper as Robinson et al., 2017

    The Results (Negative and positive life events; page not provided) and Discussion (Summary; page not provided) link patients’ life events to mismatches between their Global Rating of Change and PHQ-9 scores. The paper does not establish that interventions affect agreement or calculations of sensitivity to change, and it compares two patient-reported measures rather than therapist and patient ratings. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [21]Brown G, Harris T Social origins of depression. London: Tavistock, 1978. 724871

Cited by

Sorted by citations

Related

Authors
Robinson, J., Khan, N., Fusco, L., Malpass, A., Lewis, G., & Dowrick, C.
Affiliations
  • University of Liverpool (GB)
  • University of Bristol (GB)
  • University College London (GB)
Corresponding author
Dowrick, Christopher
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2017-04
Volume
7
Issue
4
Pages
e014519
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2016-014519
PMC
PMC5566896
OpenAlex
W2610232737
Cited by
39
References
29
Citations by year
2026: 5 · 2025: 6 · 2024: 1 · 2023: 7 · 2022: 6 · 2021: 3 · 2020: 7 · 2019: 3 · 2018: 1
FWCI
3.92
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by)
Funders
Programme Grants for Applied Research
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
depression, global rating of change, PHQ-9, patient-reported outcomes, patient perspectives, primary care, antidepressant prescribing, treatment expectations, life events, symptom fluctuation, self-motivation
MeSH terms
Patient Health Questionnaire, Adult, Antidepressive Agents, Data Interpretation, Statistical, Depression, England, Female, Humans, Male, Middle Aged, Practice Patterns, Physicians', Primary Health Care, Surveys and Questionnaires, Reproducibility of Results, Patient Satisfaction, Health Care Surveys, Qualitative Research

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