Julia M P Poritz1, Joseph Mignogna2,3,4, Aimee J Christie5,6, Sally A Holmes5,6, Herb Ames5,6. 1. a TIRR Memorial Hermann , Houston , Texas , USA. 2. b VISN 17 Center of Excellence for Research on Returning War Veterans , Waco , Texas , USA. 3. c Central Texas Veterans Health Care System , Temple , Texas , USA. 4. d Texas A&M College of Medicine , Temple , Texas , USA. 5. e Michael E. DeBakey VA Medical Center , Houston , Texas , USA. 6. f Baylor College of Medicine , Houston , Texas , USA.
Abstract
CONTEXT: Although depression is not inevitable following spinal cord injury/dysfunction (SCI/D), it can have a negative impact on rehabilitation. Evidence-based assessment of depression utilizing self-report instruments, such as the Patient Health Questionnaire-9 (PHQ-9), is considered good clinical practice. Although the PHQ-9 has been studied in individuals with SCI/D, little is known about the clinical utility of the Patient Health Questionnaire-2 (PHQ-2). Traditional cutoff scores for the PHQ-2 were examined to explore their operating characteristics as related to PHQ-9 results. METHODS: Archival data were collected for 116 Veterans with SCI/D who completed the PHQ-2 and PHQ-9 as one component of their routine, comprehensive SCI annual evaluation at a Veterans Affairs Medical Center. Logistic regressions were performed to determine the impact of different cutoff scores for the PHQ-2 on the likelihood that participants would endorse clinically significant levels of depressive symptoms on the PHQ-9 (≥10). RESULTS: Using a cutoff score of 3 or greater correctly classified 94.8% of the cases, outperforming the other cutoff scores. A cutoff score of 3 or greater had a sensitivity of 83.3% and specificity of 97.8%, and yielded a positive predictive value of 90.9% and a negative predictive value of 95.7%. CONCLUSION: The PHQ-2 shows promise as a clinically useful screener in the community-residing SCI/D population. Findings regarding the presence of suicidal ideation emphasize the importance of routine screening for depressive symptomatology in the SCI/D population. Future research should investigate the role of the PHQ-2 in clinical decision-making and treatment monitoring.
CONTEXT: Although depression is not inevitable following spinal cord injury/dysfunction (SCI/D), it can have a negative impact on rehabilitation. Evidence-based assessment of depression utilizing self-report instruments, such as the Patient Health Questionnaire-9 (PHQ-9), is considered good clinical practice. Although the PHQ-9 has been studied in individuals with SCI/D, little is known about the clinical utility of the Patient Health Questionnaire-2 (PHQ-2). Traditional cutoff scores for the PHQ-2 were examined to explore their operating characteristics as related to PHQ-9 results. METHODS: Archival data were collected for 116 Veterans with SCI/D who completed the PHQ-2 and PHQ-9 as one component of their routine, comprehensive SCI annual evaluation at a Veterans Affairs Medical Center. Logistic regressions were performed to determine the impact of different cutoff scores for the PHQ-2 on the likelihood that participants would endorse clinically significant levels of depressive symptoms on the PHQ-9 (≥10). RESULTS: Using a cutoff score of 3 or greater correctly classified 94.8% of the cases, outperforming the other cutoff scores. A cutoff score of 3 or greater had a sensitivity of 83.3% and specificity of 97.8%, and yielded a positive predictive value of 90.9% and a negative predictive value of 95.7%. CONCLUSION: The PHQ-2 shows promise as a clinically useful screener in the community-residing SCI/D population. Findings regarding the presence of suicidal ideation emphasize the importance of routine screening for depressive symptomatology in the SCI/D population. Future research should investigate the role of the PHQ-2 in clinical decision-making and treatment monitoring.
Entities:
Keywords:
Depression; Patient Health Questionnaire; Screening; Spinal cord injury
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Charles H Bombardier; Claire Z Kalpakjian; Daniel E Graves; Joshua R Dyer; Denise G Tate; Jesse R Fann Journal: Arch Phys Med Rehabil Date: 2012-04-30 Impact factor: 3.966
Authors: Janneke M de Man-van Ginkel; Floor Gooskens; Vera P M Schepers; Marieke J Schuurmans; Eline Lindeman; Thóra B Hafsteinsdóttir Journal: Nurs Res Date: 2012 Sep-Oct Impact factor: 2.381
Authors: Claire Z Kalpakjian; Charles H Bombardier; Katherine Schomer; Pat A Brown; Kurt L Johnson Journal: J Spinal Cord Med Date: 2009 Impact factor: 1.985
Authors: Nicolaas P A Zuithoff; Yvonne Vergouwe; Michael King; Irwin Nazareth; Manja J van Wezep; Karel G M Moons; Mirjam I Geerlings Journal: BMC Fam Pract Date: 2010-12-13 Impact factor: 2.497
Authors: Ming-Yi Hsu; Shih-Chien Huang; Pang-Li Liu; Kwok-Tak Yeung; Yu-Ming Wang; Hao-Jan Yang Journal: Int J Environ Res Public Health Date: 2022-02-08 Impact factor: 3.390