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

Research output: Contribution to journalArticle

34 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

Fingerprint

Rural Hospitals
Internal Medicine
Primary Health Care
Cross-Sectional Studies
Health
Depression
Surveys and Questionnaires
Interviews
Sensitivity and Specificity
Depressive Disorder
General Hospitals

Keywords

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

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

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

In: General Hospital Psychiatry, Vol. 35, No. 6, 11.2013, p. 592-597.

Research output: Contribution to journalArticle

Inagaki, M, Ohtsuki, T, Yonemoto, N, Kawashima, Y, Saitoh, A, Oikawa, Y, Kurosawa, M, Muramatsu, K, Furukawa, TA & 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, vol. 35, no. 6, pp. 592-597. https://doi.org/10.1016/j.genhosppsych.2013.08.001
Inagaki, Masatoshi ; Ohtsuki, Tsuyuka ; Yonemoto, Naohiro ; Kawashima, Yoshitaka ; Saitoh, Akiyoshi ; Oikawa, Yuetsu ; Kurosawa, Mie ; Muramatsu, Kumiko ; Furukawa, Toshi A. ; Yamada, Mitsuhiko. / 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. In: General Hospital Psychiatry. 2013 ; Vol. 35, No. 6. pp. 592-597.
@article{06d1e1cc25ea4233ae80ea90f5ceb789,
title = "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",
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.",
keywords = "Depression, Internal medicine, Patient Health Questionnaire, Primary care, Screening",
author = "Masatoshi Inagaki and Tsuyuka Ohtsuki and Naohiro Yonemoto and Yoshitaka Kawashima and Akiyoshi Saitoh and Yuetsu Oikawa and Mie Kurosawa and Kumiko Muramatsu and Furukawa, {Toshi A.} and Mitsuhiko Yamada",
year = "2013",
month = "11",
doi = "10.1016/j.genhosppsych.2013.08.001",
language = "English",
volume = "35",
pages = "592--597",
journal = "General Hospital Psychiatry",
issn = "0163-8343",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Validity of the Patient Health Questionnaire (PHQ)-9 and PHQ-2 in general internal medicine primary care at a Japanese rural hospital

T2 - A cross-sectional study

AU - Inagaki, Masatoshi

AU - Ohtsuki, Tsuyuka

AU - Yonemoto, Naohiro

AU - Kawashima, Yoshitaka

AU - Saitoh, Akiyoshi

AU - Oikawa, Yuetsu

AU - Kurosawa, Mie

AU - Muramatsu, Kumiko

AU - Furukawa, Toshi A.

AU - Yamada, Mitsuhiko

PY - 2013/11

Y1 - 2013/11

N2 - 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.

AB - 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.

KW - Depression

KW - Internal medicine

KW - Patient Health Questionnaire

KW - Primary care

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=84887028776&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84887028776&partnerID=8YFLogxK

U2 - 10.1016/j.genhosppsych.2013.08.001

DO - 10.1016/j.genhosppsych.2013.08.001

M3 - Article

C2 - 24029431

AN - SCOPUS:84887028776

VL - 35

SP - 592

EP - 597

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

SN - 0163-8343

IS - 6

ER -