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Validation of PHQ-2 and PHQ-9 to Screen for Major Depression in the Primary Care Population
Open accessAbstract
PURPOSE: Although screening for unipolar depression is controversial, it is potentially an efficient way to find undetected cases and improve diagnostic acumen. Using a reference standard, we aimed to validate the 2- and 9-question Patient Health Questionnaires (PHQ-2 and PHQ-9) in primary care settings. The PHQ-2 comprises the first 2 questions of the PHQ-9. METHODS: Consecutive adult patients attending Auckland family practices completed the PHQ-9, after which they completed the Composite International Diagnostic Interview (CIDI) depression reference standard. Sensitivities and specificities for PHQ-2 and PHQ-9 were analyzed. RESULTS: There were 2,642 patients who completed both the PHQ-9 and the CIDI. Sensitivity and specificity of the PHQ-2 for diagnosing major depression were 86% and 78%, respectively, with a score of 2 or higher and 61% and 92% with a score 3 or higher; for the PHQ-9, they were 74% and 91%, respectively, with a score of 10 or higher. For the PHQ-2 a score of 2 or higher detected more cases of depression than a score of 3 or higher. For the PHQ-9 a score of 10 or higher detected more cases of major depression than the PHQ determination of major depression originally described by Spitzer et al in 1999. CONCLUSIONS: We report the largest validation study of the PHQ-2 and PHQ-9, compared with a reference standard interview, undertaken in an exclusively primary care population. The PHQ-2 score or 2 or higher had good sensitivity but poor specificity in detecting major depression. Using a PHQ-2 threshold score of 2 or higher rather than 3 or higher resulted in more depressed patients being correctly identified. A PHQ-9 score of 10 or higher appears to detect more depressed patients than the originally described PHQ-9 scoring for major depression.
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“The PHQ-2 score was used to estimate the severity of depression, which assessed the frequency of depressed mood and anhedonia over the past two weeks [22].”
From Association between first-line antidepressant use and risk of dementia in older adults: a retrospective cohort study (2023) · cites this paper as [22]
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In the citing paper
“The PHQ-8 has excellent internal consistency (Cronbach α=.89) and excellent test-retest reliability [47].”
From Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial (2023) · cites this paper as [47]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The PHQ-8 has excellent internal consistency (Cronbach α of .89 in primary care settings and .88 in this study at t0) and excellent test–retest reliability [49].”
From Feasibility and Preliminary Efficacy of Web-Based and Mobile Interventions for Common Mental Health Problems in Working Adults: Multi-Arm Randomized Pilot Trial (2022) · cites this paper as [49]
Experimental — accuracy not yet measured
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The Psychological Impact of Adult Traumatic Brachial Plexus Injury
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The patient health questionnaire (PHQ)
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Shah, N. P., Raheem, A., Sideris, M. C., Velauthar, L., & Saeed, F. (2020) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2020.07.060 · Cited by 41
“A PHQ-2 score of 3 or more was interpreted as likely MDD (sensitivity, specificity) [8].”
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“All patients with a PHQ-2 score of 2 or more [34,35] will receive additional information from the research team.”
BackgroundBurns, R. J., Deschênes, S. S., & Schmitz, N. (2015) · Diabetic Medicine · doi:10.1111/dme.12860 · Cited by 47
Wang, J., Guo, W., Zhang, L., Deng, W., Wang, H.-Y., Yu, J., Luo, S., Huang, M., Dong, Z., Li, D., et al. (2017) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2017.04.001 · Cited by 43
“Of the 5 items about depression, the first 2 items (Felt so depressed that nothing could cheer you up and had no interest or pleasure in doing things) were similar to the 2 items of Patient Health Questionnaire-2 (PHQ-2), which showed good sensitivity but poor specificity in detecting major depression when scored 2 or…”
BackgroundResultKwak, E.-J., Ji, Y., Baek, S., & Baek, Y. S. (2020) · Journal of Dental Sciences · doi:10.1016/j.jds.2020.07.009 · Cited by 43
Elhadi, M., Alsoufi, A., Msherghi, A. A. A., Alshareea, E. A. A., Ashini, A., Nagib, T., Abuzid, N., Abodabos, S., Alrifai, H., Gresea, E., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.632496 · Cited by 42
Major depression in primary care: making the diagnosis
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The effects of caregiver depression on childhood asthma
Wood, B. L., Brown, E. S., Lehman, H. K., Khan, D. A., Lee, M. J., & Miller, B. D. (2018) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2018.06.031 · Cited by 42
Rouf, A., Masoodi, M. A., Dar, M. M., Khan, M. S., & Bilquise, R. (2021) · Journal of Clinical Tuberculosis and Other Mycobacterial Diseases · doi:10.1016/j.jctube.2021.100281 · Cited by 42
“Symptoms were categorized using established cut-points 5, 10, 15 and 20 (mild, moderate, moderately severe and severe depression, respectively) [19,20] to determine the different severities of exposure, and interval level scoring was computed to examine changes in intensity of depression when the comorbid TB is treate…”
MethodBock, K., Bendstrup, E., Hilberg, O., & Løkke, A. (2017) · European Clinical Respiratory Journal · doi:10.1080/20018525.2017.1332931 · Cited by 38
“Studies using various other screening tools such as Zung, PHQ-2 (Patient Health Questionnaire), PHQ-9, BASDEC (Brief Assessment Schedule Depression Cards) and GHQ (General Health Questionnaire) were excluded since these are either poorly or not at all validated for this patient group or they are only used in a single…”
MethodDepression, anxiety and related factors among Syrian breast cancer patients: a cross-sectional study
Soqia, J., Al-shafie, M., Yakoub‐Agha, L., Alameer, M. B., Alhomsi, D., Saadoun, R., & Saifo, M. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04469-y · Cited by 41
“Social status had a stronger association with the need for further assessment for MDD, with divorced women showing the strongest association, followed by widowed and married women compared to single women.”
BackgroundInfluentialImproving Cardiac Rehabilitation Adherence in Patients With Lower Socioeconomic Status
Gaalema, D. E., Khadanga, S., Savage, P. D., Yant, B., Katz, B. R., DeSarno, M., & Ades, P. A. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.3338 · Cited by 43
Kerper, L. F., Spies, C., Tillinger, J., Wegscheider, K., Salz, A.-L., Weiß-Gerlach, E., Neumann, T., & Krampe, H. (2014) · Clinical Health Promotion - Research and Best Practice for patients staff and community · doi:10.29102/clinhp.14002 · Cited by 44
Mental Health During the COVID-19 Pandemic in the United States: Online Survey
Jewell, J. S., Farewell, C. V., Welton‐Mitchell, C., Lee‐Winn, A. E., Walls, J., & Leiferman, J. A. (2020) · JMIR Formative Research · doi:10.2196/22043 · Cited by 42
“The PHQ-2 has a range of 0-6 and was dichotomized for analyses using a cutoff score of ≥3 [28,29].”
MethodAthanasiadis, D. I., Hernandez, E., Hilgendorf, W. A., Roper, A., Embry, M., Selzer, D. J., & Stefanidis, D. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.11.021 · Cited by 41
“Compared to before the disruption of my normal routine by the COVID-19 pandemic I tend to consume large quantities of food in a short period of time ___ Compared to before the disruption of your normal routine by the COVID-19 pandemic I eat despite not feeling hungry ___ Related to depression Compared to before the di…”
Senn, N., & Monod, S. (2015) · Frontiers in Medicine · doi:10.3389/fmed.2015.00078 · Cited by 42
“Mood disorder PHQ-9 Se= 77, Sp= 83 (any dep) ~1–2min X X (43) PHQ-2 Se= 82–86, Sp= 67–78 (any dep) <1min X X (44) Two questions (similar to PHQ-2) Se= 81–96, Sp= 51–72 <1min (45) GDS (15 questions) Se= 81, Sp= 0.”
Are depression and poor sexual health neglected comorbidities? Evidence from a population sample
Field, N. M., Prah, P., Mercer, C. H., Rait, G., King, M., Cassell, J., Tanton, C., Heath, L., Mitchell, K. R., Clifton, S., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010521 · Cited by 46
“Participants were deemed to have depressive symptoms if they had a total score of three or more, a cut-off that has been previously validated.(25) We identified a number of permutations in the groups that might be selected for analysis.”
MethodPsychometric Properties of the Patient Health Questionnaire-9 in Elderly Chilean Primary Care Users
Aslan, J., Félix Cova, S., Saldivia, S., Bustos, C., Inostroza, C., Rincón, P., Ortiz, C., & Vasily Buhring, S. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.555011 · Cited by 43
“inter-rater and test-retest reliability, and is a valid gold standard for MDD diagnosis (37, 38), with evidence of validity in multiple international studies, including Chile (4, 39, 40).”
MethodRaja, A., Spertus, J. A., Yeh, R. W., & Secemsky, E. A. (2020) · Vascular Medicine · doi:10.1177/1358863x20977016 · Cited by 41
Miller, P., Newby, D., Walkom, E., Schneider, J., Li, S. C., & Evans, T.-J. (2021) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2020.10.002 · Cited by 39
Kim, M., Jung, S., Park, J. E., Sohn, J. H., Seong, S. J., Kim, B., Chang, S. M., Hong, J. P., Hahm, B., & Yeom, C. (2023) · Psychiatry Investigation · doi:10.30773/pi.2023.0100 · Cited by 39
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Khan, M. R., Young, K. E., Caniglia, E. C., Fiellin, D. A., Maisto, S. A., Marshall, B. D. L., Edelman, E. J., Gaither, J. R., Chichetto, N. E., Tate, J., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.0895 · Cited by 40
Mensinger, J. L., Brom, H. M., Havens, D. S., Costello, A., D’Annunzio, C., Durning, J. D., Bradley, P. K., Copel, L. C., Maldonado, L. T., Smeltzer, S. C., et al. (2021) · Applied Nursing Research · doi:10.1016/j.apnr.2021.151517 · Cited by 37
“, 2006), the Patient Health Questionnaire-2 for depressive symptoms (PHQ-2, Kroenke et al., 2003; Arroll et al., 2010), the Impact of Events Scale-Revised for traumatic stress (IES-R, Creamer et al.”
MethodNikendei, C., Kindermann, D., Brandenburg-Ceynowa, H., Derreza-Greeven, C., Zeyher, V., Junne, F., Friederich, H.-C., & Bozorgmehr, K. (2019) · Health Policy · doi:10.1016/j.healthpol.2019.07.008 · Cited by 38
Motivational interviewing improves depression outcome in primary care: A cluster randomized trial.
Keeley, R. D., Brody, D. S., Engel, M. D., Burke, B. L., Nordstrom, K., Moralez, E. A., Dickinson, L. M., & Emsermann, C. B. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000124 · Cited by 42
The pain–depression dyad and the association with sleep dysfunction in chronic rhinosinusitis
Cox, D. R., Ashby, S., Mace, J. C., DelGaudio, J. M., Smith, T. L., Orlandi, R. R., & Alt, J. A. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21843 · Cited by 38
Jung, M. S., & Visovatti, M. A. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-016-3481-y · Cited by 39
“Participants were excluded for clinical depression assessed by the Patient Health Questionnaire [18] and coexisting debilitating medical conditions that could affect abilities to perform cognitive tasks.”
MethodA brief screening measure for binge eating in primary care
Dorflinger, L. M., Ruser, C. B., & Masheb, R. M. (2017) · Eating Behaviors · doi:10.1016/j.eatbeh.2017.03.009 · Cited by 38
“finding of a more modest positive predictive value is consistent with other brief screeners used within primary care such as the PHQ [22].”
BackgroundResultInfluentialNight eating among veterans with obesity
Dorflinger, L. M., Ruser, C. B., & Masheb, R. M. (2017) · Appetite · doi:10.1016/j.appet.2017.07.011 · Cited by 38
“The two-item measure assesses the frequency 118 of depressed mood and anhedonia during the previous two weeks, and has demonstrated good 119 sensitivity for detecting major depression in patients seen in primary care (21).”
BackgroundPfoh, E. R., Janmey, I., Anand, A., Martinez, K. A., Katzan, I. L., & Rothberg, M. B. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-05856-5 · Cited by 39
Public Perceptions of Resuming Elective Surgery During the COVID-19 Pandemic
Moverman, M. A., Puzzitiello, R. N., Pagani, N. R., Barnes, C. L., Jawa, A., & Menendez, M. E. (2020) · The Journal of Arthroplasty · doi:10.1016/j.arth.2020.07.037 · Cited by 37
“We determined the rate of major depressive disorder with the Patient Health Questionnaire (PHQ-2) [16], and assessed health literacy using the single health literacy screening question [17].”
Impact of COVID-19 Pandemic on California Farmworkers’ Mental Health and Food Security
Mora, A. M., Lewnard, J. A., Kogut, K., Rauch, S., Morga, N., Jewell, N., Cuevas, M., & Eskenazi, B. (2022) · Journal of Agromedicine · doi:10.1080/1059924x.2022.2058664 · Cited by 38
Leightley, D., Williamson, C., Rona, R. J., Carr, E., Shearer, J., Davis, J. P., Simms, A., Fear, N. T., Goodwin, L., & Murphy, D. (2022) · JMIR mhealth and uhealth · doi:10.2196/38991 · Cited by 38
“I/C I/C I/C I/C I/C I/C I/C Depression (2-item Patient Health Questionnaire [PHQ2]) [24]”
Tele, A., Carvajal-Vélez, L., Nyongesa, V., Åhs, J. W., Mwaniga, S., Kathono, J., Yator, O., Njuguna, S., Kanyanya, I., Amin, N., et al. (2022) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2022.10.003 · Cited by 43
The OCI-4: An ultra-brief screening scale for obsessive-compulsive disorder
Amitai Abramovitch, A., Abramowitz, J. S., & McKay, D. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102354 · Cited by 42
Sayah, F. A., Majumdar, S. R., Egede, L. E., & Johnson, J. A. (2015) · Journal of Health Communication · doi:10.1080/10810730.2015.1012235 · Cited by 37
Suzuki, K., Kumei, S., Ohhira, M., Nozu, T., & Okumura, T. (2015) · PLoS ONE · doi:10.1371/journal.pone.0119147 · Cited by 34
“The PHQ-2 is comprised of the first two questions from the PHQ9 For example, sensitivity and specificity of the PHQ-2 for diagnosing major depression were 86% and 76% (cut-off point 2) and 61% and 92% with (cut-off point 3); for the PHQ-9, they were 74% and 91% (cut-off point 10) in New Zealand [6].”
BackgroundHow Do Social Needs Cluster Among Low-Income Individuals?
Kreuter, M. W., Garg, R., Li, L., McNulty, L., Thompson, T., McQueen, A., & Luke, A. A. (2020) · Population Health Management · doi:10.1089/pop.2020.0107 · Cited by 38
“30 Causality cannot be established from these cross-sectional associations and is likely bidirectional 20 ; for example, longitudinal studies have shown basic needs predict depressive symptoms, 31 but also vice versa.”
Baum, A., Wisnivesky, J. P., Basu, S., Siu, A. L., & Schwartz, M. D. (2020) · JAMA · doi:10.1001/jama.2020.14381 · Cited by 38
Lewin, K. M., Meshi, D., Schuster, A. M., & Cotten, S. R. (2023) · Aging & Mental Health · doi:10.1080/13607863.2022.2068133 · Cited by 37
“Therefore we dichotomized depressive symptoms according to a validated cut-point (Arroll et al., 2010), with a score of 2 or higher denoting high depressive symptoms and a score of 1 or below denoting low depressive symptoms.”
BackgroundMethodInfluentialRasmussen, N. H., Smith, S. A., Maxson, J. A., Bernard, M., Cha, S. S., Agerter, D. C., & Shah, N. D. (2013) · Primary care diabetes · doi:10.1016/j.pcd.2013.04.006 · Cited by 37
“d The patient health questionnaire–depression scale (PHQ-9; [42]) consists of nine signs and symptoms of depression taken from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition [43].”
BackgroundMethodAssessing validity of a depression screening instrument in the absence of a gold standard
Gelaye, B., Tadesse, M. G., Williams, M. A., Fann, J. R., Stoep, A. V., & Zhou, X. (2014) · Annals of Epidemiology · doi:10.1016/j.annepidem.2014.04.009 · Cited by 37
“Indeed, some investigators have used the CIDI as a gold standard to evaluate the diagnostic accuracy of the PHQ-9 [13].”
BackgroundMethodMaking the Social Determinants of Health a Routine Part of Medical Care
Nuruzzaman, N., Broadwin, M., Kourouma, K., & Olson, D. P. (2015) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2015.0036 · Cited by 36
Post-stroke depression among stroke survivors attending two hospitals in Kampala Uganda
Gyagenda, J. O., Ddumba, E., Odokonyero, R. F., Kaddumukasa, M., Sajatovic, M., Smyth, K., & Katabira, E. (2016) · African Health Sciences · doi:10.4314/ahs.v15i4.22 · Cited by 35
Cirillo, L., Cutruzzulà, R., Somma, C., Gregori, M., Cestone, G., Pizzarelli, C., Toccafondi, A., Pizzarelli, F., & Dattolo, P. C. G. (2018) · Blood Purification · doi:10.1159/000491014 · Cited by 36
Liu, X., Peng, C., Yu, Y., Yang, M., Qing, Z., Qiu, X., & Yang, X. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00368 · Cited by 35
“Depression and anxiety are two of the most common psychiatric symptoms (17, 18).”
BackgroundDifferent Correlates of COVID-19-Related Adherent and Dysfunctional Safety Behavior
Weismüller, B., Schweda, A., Dörrie, N., Musche, V., Fink, M., Dinse, H., Skoda, E., Teufel, M., & Bäuerle, A. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2020.625664 · Cited by 36
Jonathan, G., Dopke, C. A., Michaels, T., Bank, A., Martin, C. R., Adhikari, K., Krakauer, R. L., Ryan, C., McBride, A., Babington, P., et al. (2021) · JMIR Mental Health · doi:10.2196/20424 · Cited by 39
Manfuku, M., Nishigami, T., Mibu, A., Tanaka, K., Kitagaki, K., & Sumiyoshi, K. (2019) · Breast Cancer · doi:10.1007/s12282-019-00979-y · Cited by 34
A new PHQ-2 for Chinese adolescents: identifying core items of the PHQ-9 by network analysis
Liang, K., Chen, S., Zhao, Y., Ren, Y., Ren, Z., & Chi, X. (2023) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-023-00559-1 · Cited by 38
“Besides, the screening ability of the PHQ-9 original algorithm, which emphasizes anhedonia and depressed mood, is unsatisfactory [23, 24].”
BackgroundAttention-based acoustic feature fusion network for depression detection
Xu, X. D., Wang, Y., Wei, X., Wang, F., & Zhang, X. (2024) · Neurocomputing · doi:10.1016/j.neucom.2024.128209 · Cited by 38
Lorian, C. N., Titov, N., & Grisham, J. R. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.10.003 · Cited by 37
Karasz, A., Patel, V. V., Kabita, M., & Shimu, P. (2013) · Progress in community health partnerships · doi:10.1353/cpr.2013.0046 · Cited by 35
“We chose the PHQ-2 because of its brevity, its comparable predictive utility as compared with the PHQ-9, and its wide use in international settings (67-70) Community Health Workers translated and back-translated the overall survey from Bengali and pre-tested the Bengali version with the Bondhu members, incorporating c…”
MethodLillis, T. A., Tirone, V., Gandhi, N., Weinberg, S., Nika, A., Sequeira, W., Hobfoll, S. E., Block, J. A., & Jolly, M. (2018) · Arthritis Care & Research · doi:10.1002/acr.23593 · Cited by 35
The French version of the HSCL-25 has now been validated for use in primary care
Nabbe, P., Reste, J. L., Guillou-Landreat, M., Gatineau, F., Floc'h, B. L., Montier, T., van Marwijk, H. V., & Royen, P. V. (2019) · PLoS ONE · doi:10.1371/journal.pone.0214804 · Cited by 32
“To increase the sensitivity, the HSCL-25 could be combined with a screening tool such as the PHQ-2 [44].”
MethodInfluentialSauer, C., Weis, J., Faller, H., Junne, F., Hönig, K., Bergelt, C., Hornemann, B., Stein, B., Teufel, M., Goerling, U., et al. (2019) · Acta Oncologica · doi:10.1080/0284186x.2019.1631471 · Cited by 39
Diabetes stigma, parent depressive symptoms and Type-1 diabetes glycemic control in India
Capistrant, B. D., Friedemann‐Sánchez, G., & Pendsey, S. (2019) · Social Work in Health Care · doi:10.1080/00981389.2019.1679321 · Cited by 36
“Parents’ mental health was assessed in the survey with the PHQ-9 (Arroll et al., 2010), which assesses depressive symptom frequency and has been employed frequently in primary care medical settings similar to this study.”
BackgroundMethodInfluentialKowalski, A. J., Poongothai, S., Chwastiak, L., Hutcheson, M., Tandon, N., Khadgawat, R., Sridhar, G. R., Aravind, S. R., Sosale, B., Anjana, R. M., et al. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.06.013 · Cited by 37
Prevalence and Predictors of Depression Among Medical Residents in Western Saudi Arabia
Alshardi, A., & Farahat, F. M. (2019) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-019-09667-7 · Cited by 35
Zhong, S., Wang, S., Ding, K., Tan, W., & Zhou, L. (2024) · BMC Public Health · doi:10.1186/s12889-024-20020-y · Cited by 34
“The cutoff point is in accordance with the study protocol and has been used in previous studies [16].”
ResultClinical utility of screening for clinical depression and bipolar disorder
Mitchell, A. J. (2011) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32834de45b · Cited by 36
Improving primary care for persons with spinal cord injury: Development of a toolkit to guide care
Milligan, J., Lee, J., Hillier, L. M., Slonim, K., & Craven, B. C. (2018) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2018.1468584 · Cited by 34
Theeke, L. A., Carpenter, R. D., Mallow, J. A., & Theeke, E. (2018) · Applied Nursing Research · doi:10.1016/j.apnr.2018.12.001 · Cited by 35
Nepal, S. K., Wang, W., Vojdanovski, V., Huckins, J. F., DaSilva, A. W., Meyer, M. L., & Campbell, A. T. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3502043 · Cited by 40
“Similarly, depression is multifaceted, but we will focus on anhedonia and negative afect components, given their gross diagnostic abilities of anxiety and depression in college students [1].”
BackgroundVrubļevska, J., Trapencieris, M., & Rancāns, E. (2017) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2017.1397191 · Cited by 36
“The PHQ-9 has been validated in community samples [21,22], psychiatric patients [23], and patients with somatic conditions [24–27], as well as in primary care patients and patients in general hospital settings [8,17,28,29].”
BackgroundResident Preferences for Program Director Role in Wellness Management
Kolarik, R. C., O'Neal, R. L., & Ewing, J. A. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-018-4367-0 · Cited by 33
“To screen this population of residents for depression, we used the 2-question Patient Health Questionnaire (PHQ-2) instrument with the questions BOver the past two weeks, have you been bothered by any of the following problems: ‘Little Interest or pleasure in doing things’ and ‘Feeling down, depressed or hopeless’?^ T…”
MethodFerreira, T. B., Silva, M. S., & Salgado, J. (2019) · The Psychologist Practice & Research Journal · doi:10.33525/pprj.v1i2.36 · Cited by 34
Sharing in care: engaging care partners in the care and communication of breast cancer patients
Wolff, J. L., Aufill, J., Echavarria, D. M., Heughan, J.-A., Lee, K. T., Connolly, R. M., Fetting, J. H., Jelovac, D., Papathakis, K., Riley, C. D., et al. (2019) · Breast Cancer Research and Treatment · doi:10.1007/s10549-019-05306-9 · Cited by 33
Jang, B. N., Lee, H. J., Joo, J. H., Park, E., & Jang, S. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02628-7 · Cited by 35
Johnson, A. K., Blackstone, S. R., Skelly, A. W., & Simmons, W. R. (2020) · Health Professions Education · doi:10.1016/j.hpe.2020.04.003 · Cited by 35
Rubin, M., Bicki, A., Papini, S., Smits, J. A. J., Telch, M. J., & Gray, J. S. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.07.053 · Cited by 38
Jardon, C., & Choi, K. R. (2022) · Journal of the American Psychiatric Nurses Association · doi:10.1177/10783903211072222 · Cited by 38
“Health Questionnaire (PHQ-2) is a widely used, validated screener for clinical depression (Arroll et al., 2010; Löwe et al., 2005).”
MethodNjoroge, W., White, L. K., Waller, R. E., Forkpa, M., Himes, M. M., Morgan, K., Seidlitz, J., Chaiyachati, B. H., Barzilay, R., Kornfield, S. L., et al. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.0597 · Cited by 33
Depression in the Primary Care Setting
Ellis, P., Kitay, B. M., & Schmidt, C. J. (2019) · New England Journal of Medicine · doi:10.1056/nejmc1903259 · Cited by 35
Palermo, T. M., de la Vega, R., Dudeney, J., Murray, C., & Law, E. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.10.003 · Cited by 32
“The Patient Health Questionnaire 2 [12] screens for depressive symptoms, with scores of 3 or higher targeting release of a supplementary module to address negative mood.”
BackgroundFood insecurity in adults with severe mental illness: A systematic review with meta‐analysis
Smith, J., Stevens, H., Lake, A. A., Teasdale, S., & Giles, E. L. (2024) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12969 · Cited by 34
Nwaogu, J. M., Chan, A. P. C., Sunindijo, R. Y., Darko, A., Yang, Y., & Salihu, D. (2022) · Journal of Construction Engineering and Management · doi:10.1061/jcemd4.coeng-12253 · Cited by 32
Alamri, S. H., Bari, A. I., & Ali, A. T. (2017) · Annals of Saudi Medicine · doi:10.5144/0256-4947.2017.122 · Cited by 32
Virtual Human Questionnaire for Analysis of Depression, Anxiety and Personality
Jaiswal, S., Valstar, M., Kusumam, K., & Greenhalgh, C. (2019) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3308532.3329469 · Cited by 33
“Another major advantage with using such standard questionnaires is that the scores from these questionnaires have been extensively validated by many large studies [4, 12, 16] and hence can be directly used as a measure of severity of the condition being considered.”
BackgroundScoppetta, O., Cassiani-Miranda, C. A., Arocha-Díaz, K. N., Cabanzo-Arenas, D. F., & Campo‐Arias, A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.096 · Cited by 38
Giuliani, M., Gorini, A., Barbieri, S., Veglia, F., & Tremoli, E. (2020) · Psychology and Health · doi:10.1080/08870446.2020.1830093 · Cited by 32
“…and compared their results on the PHQ-2 with those obtained administering the Composite International Diagnostic Interview (CIDI), finding that a cutoff 2 allows to discriminate between depressed and non-depressed patients (sensitivity ¼ 0.86; specificity ¼ 0.78; PPV ¼ 0.21) (Arroll et al., 2010).”
ResultInfluentialFletcher, S. L., Chondros, P., Densley, K., Murray, E., Dowrick, C. F., Coe, A., Hegarty, K. L., Davidson, S. K., Wachtler, C., Mihalopoulos, C., et al. (2020) · British Journal of General Practice · doi:10.3399/bjgp.2020.0783 · Cited by 31
“…on an iPad, and were eligible if they reported: current depressive symptoms ( ≥ 2 on the 2-item version of the Patient Health Questionnaire [PHQ-2] 22 ); no self-reported change to antidepressant medication in the past month; had access to the internet; and sufficient written English to follow an…”
Self-citationCharacteristics of Fathers with Depressive Symptoms
Rosenthal, D. G., Learned, N., Liu, Y., & Weitzman, M. L. (2012) · Maternal and Child Health Journal · doi:10.1007/s10995-012-0955-5 · Cited by 31
Scott, J. A., Rouhani, S. A., Greiner, A. L., Albutt, K. H., Kuwert, P., Hacker, M. R., VanRooyen, M. J., & Bartels, S. A. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-007057 · Cited by 32
Swartz, R. H., Cayley, M. L., Lanctôt, K. L., Murray, B. J., Cohen, A., Thorpe, K. E., Sicard, M. N., Lien, K. R., Sahlas, D. J., & Herrmann, N. (2017) · PLoS ONE · doi:10.1371/journal.pone.0174451 · Cited by 30
Manea, L., Boehnke, J. R., Gilbody, S. M., Moriarty, A. S., & McMillan, D. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-015247 · Cited by 32
Rossa-Roccor, V., Richardson, C. G., Murphy, R. A., & Gadermann, A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0252358 · Cited by 33
McMahon, G. E., Douglas, A., Casey, K., & Ahern, E. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.142 · Cited by 30
McElroy, J. A., Wintemberg, J. J., Cronk, N. J., & Everett, K. D. (2015) · Psychology and Sexuality · doi:10.1080/19419899.2015.1076504 · Cited by 31
Current Smoking as a Predictor of Chronic Musculoskeletal Pain in Young Adult Twins
Holley, A. L., Law, E. F., Tham, S. W., Myaing, M. T., Noonan, C., Strachan, E. D., & Palermo, T. M. (2013) · Journal of Pain · doi:10.1016/j.jpain.2013.04.012 · Cited by 31
“The use of these 2 items as a screen for depression has been validated and used in both adolescent and adult samples.(3,43)”
MethodBaum, M. A., Druckman, J. N., Simonson, M. D., Lin, J., & Perlis, R. H. (2024) · American Journal of Political Science · doi:10.1111/ajps.12827 · Cited by 31
Wang, B., Peng, X., Liang, B., Fu, L., Lu, Z., Li, X., Tian, T., Xiao, X., Liu, J., Shi, T., et al. (2023) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2023.100825 · Cited by 30
Clinical Practice Guideline: Suicide Risk Assessment
Zaleski, M. E., Johnson, M. L., Valdez, A. M., Bradford, J. Y., Reeve, N. E., Horigan, A., Killian, M., Reeve, N. E., Slivinski, A., Stapleton, S. J., et al. (2018) · Journal of Emergency Nursing · doi:10.1016/j.jen.2018.07.012 · Cited by 34
Woods, L. S., Duff, J. S., Roehrer, E., Walker, K., & Cummings, E. A. (2019) · JMIR Nursing · doi:10.2196/14633 · Cited by 30
“The co-design team then conducted a literature review of the psychological care recommendations for HF [7], and clinicians communicated their use of the depression screen tool (Patient Health Questionnaire-2, PHQ-2 score) [32,33] routinely used in current practice.”
BackgroundMethodPark, J., & Kim, B. (2021) · Journal of Urban Health · doi:10.1007/s11524-020-00511-0 · Cited by 31
“The cutoff points of the PHQ-2 and GAD-2 has been validated for diagnosed MDD and GAD [11, 18, 19].”
MethodNwosu, A. D. G., Ossai, E. N., Onwuasoigwe, O., Ezeigweneme, M., & Okpamen, J. (2021) · Journal of Public Health Research · doi:10.4081/jphr.2021.1900 · Cited by 30
Rosenberg, D. E., Lin, E. H. B., Peterson, D., Ludman, E. J., Korff, M. V., & Katon, W. J. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.10.017 · Cited by 32
“A recent systematic review found that a cutoff of 10 or higher on the PHQ-9 was shown to have high sensitivity (80%) and specificity (92%) for a diagnosis of major depression among adults [13,14].”
Background
Metadata
- Authors
- Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., Falloon, K., & Hatcher, S.
- Affiliations
- University of Auckland (NZ)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2010-07-01
- Volume
- 8
- Issue
- 4
- Pages
- 348-353
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC2906530
- OpenAlex
- W2122884679
- Cited by
- 1,279
- References
- 18
- Citations by year
- 2026: 60 · 2025: 89 · 2024: 115 · 2023: 115 · 2022: 137 · 2021: 182 · 2020: 116 · 2019: 92 · 2018: 71 · 2017: 63 · 2016: 60 · 2015: 55 · 2014: 39 · 2013: 42 · 2012: 23
- FWCI
- 34.75
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion, cc-by)
- Funders
- Health Research Council of New Zealand
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- PHQ-2, PHQ-9, Patient Health Questionnaire, major depressive disorder, depression screening, primary care, screening sensitivity and specificity, Composite International Diagnostic Interview, threshold scores, general practice
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Major Depressive Disorder, Depressive Disorder, Major, Diagnosis, Computer-Assisted, Female, Humans, Male, Mass Screening, Middle Aged, New Zealand, Physicians, Family, Predictive Value of Tests, Primary Health Care, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Software, Time Factors, Prevalence, Young Adult
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