Validity of the Patient Health Questionnaire (PHQ)-9 and PHQ-2 in general internal medicine primary care at a Japanese rural hospital: A cross-sectional study

Masatoshi Inagaki, Tsuyuka Ohtsuki, Naohiro Yonemoto, Yoshitaka Kawashima, Akiyoshi Saitoh, Yuetsu Oikawa, Mie Kurosawa, Kumiko Muramatsu, Toshi A. Furukawa, Mitsuhiko Yamada

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42 Citations (Scopus)

Abstract

Objective: Two depression screening tools, Patient Health Questionnaire (PHQ)-9 and PHQ-2, have not had their validity examined in general internal medicine settings in Japan. We examined the validity of these screening tools. Methods: A total of 598 outpatients of an internal medicine clinic in a rural general hospital were enrolled consecutively and stratified by PHQ-9 score. Seventy-five patients randomly selected and 29 patients whose results from the PHQ-9 were considered to be positive for depressive disorder were then interviewed with a semistructured interview, the Mini International Neuropsychiatric Interview. We calculated diagnostic accuracy of the PHQ-9 and PHQ-2 to detect major depression and that of the suicidality item of the PHQ-9 to detect suicidality using sampling weights with multiple imputations. Results: Sensitivity and specificity for depression were 0.86 and 0.85, respectively, for the PHQ-9 with cutoff points of 4/5, and 0.77 and 0.95, respectively, for the PHQ-2 with cutoff points of 2/3. Sensitivity and specificity of the suicidality item of the PHQ-9 were 0.70 and 0.97, respectively. Conclusion: In internal medicine clinics in Japanese rural hospitals, the PHQ-2 with an optimal cutoff point for each setting plus the suicidality item of the PHQ-9 can be recommended to detect depression without missing suicidality.

Original languageEnglish
Pages (from-to)592-597
Number of pages6
JournalGeneral Hospital Psychiatry
Volume35
Issue number6
DOIs
Publication statusPublished - Nov 2013
Externally publishedYes

Keywords

  • Depression
  • Internal medicine
  • Patient Health Questionnaire
  • Primary care
  • Screening

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Inagaki, M., Ohtsuki, T., Yonemoto, N., Kawashima, Y., Saitoh, A., Oikawa, Y., Kurosawa, M., Muramatsu, K., Furukawa, T. A., & Yamada, M. (2013). Validity of the Patient Health Questionnaire (PHQ)-9 and PHQ-2 in general internal medicine primary care at a Japanese rural hospital: A cross-sectional study. General Hospital Psychiatry, 35(6), 592-597. https://doi.org/10.1016/j.genhosppsych.2013.08.001