Background: Depression is a leading cause of disability. International guidelines recommend screening for depression and the Patient Health Questionnaire 9 (PHQ-9) has been identified as the most reliable screening tool. We reviewed the evidence for using it within the primary care setting. Methods: We retrieved studies from MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library that carried out primary care-based depression screening using PHQ-9 in populations older than 12, from 1995 to 2018. Results: Forty-two studies were included in the systematic review. Most of the studies were cross-sectional (N=40, 95%), conducted in high-income countries (N=27, 71%) and recruited adult populations (N=38, 90%). The accuracy of the PHQ-9 was evaluated in 31 (74%) studies with a two-stage screening system, with structured interview most often carried out by primary care and mental health professionals. Most of the studies employed a cut-off score of 10 (N=24, 57%, total range 5 – 15). The overall sensitivity of PHQ-9 ranged from 0.37 to 0.98, specificity from 0.42 to 0.99, positive predictive value from 0.09 to 0.92, and negative predictive value from 0.8 to 1. Limitations: Lack of longitudinal studies, small sample size, and the heterogeneity of primary-care settings limited the generalizability of our results. Conclusions: PHQ-9 has been widely validated and is recommended in a two-stage screening process. Longitudinal studies are necessary to provide evidence of long-term screening effectiveness.

Screening for depression in primary care with Patient Health Questionnaire-9 (PHQ-9): A systematic review / Costantini, L.; Pasquarella, C.; Odone, A.; Colucci, M. E.; Costanza, A.; Serafini, G.; Aguglia, A.; Belvederi Murri, M.; Brakoulias, V.; Amore, M.; Ghaemi, S. N.; Amerio, A.. - In: JOURNAL OF AFFECTIVE DISORDERS. - ISSN 0165-0327. - 279:(2021), pp. 473-483. [10.1016/j.jad.2020.09.131]

Screening for depression in primary care with Patient Health Questionnaire-9 (PHQ-9): A systematic review

Pasquarella C.;Colucci M. E.;Amore M.;
2021-01-01

Abstract

Background: Depression is a leading cause of disability. International guidelines recommend screening for depression and the Patient Health Questionnaire 9 (PHQ-9) has been identified as the most reliable screening tool. We reviewed the evidence for using it within the primary care setting. Methods: We retrieved studies from MEDLINE, Embase, PsycINFO, CINAHL and the Cochrane Library that carried out primary care-based depression screening using PHQ-9 in populations older than 12, from 1995 to 2018. Results: Forty-two studies were included in the systematic review. Most of the studies were cross-sectional (N=40, 95%), conducted in high-income countries (N=27, 71%) and recruited adult populations (N=38, 90%). The accuracy of the PHQ-9 was evaluated in 31 (74%) studies with a two-stage screening system, with structured interview most often carried out by primary care and mental health professionals. Most of the studies employed a cut-off score of 10 (N=24, 57%, total range 5 – 15). The overall sensitivity of PHQ-9 ranged from 0.37 to 0.98, specificity from 0.42 to 0.99, positive predictive value from 0.09 to 0.92, and negative predictive value from 0.8 to 1. Limitations: Lack of longitudinal studies, small sample size, and the heterogeneity of primary-care settings limited the generalizability of our results. Conclusions: PHQ-9 has been widely validated and is recommended in a two-stage screening process. Longitudinal studies are necessary to provide evidence of long-term screening effectiveness.
2021
Screening for depression in primary care with Patient Health Questionnaire-9 (PHQ-9): A systematic review / Costantini, L.; Pasquarella, C.; Odone, A.; Colucci, M. E.; Costanza, A.; Serafini, G.; Aguglia, A.; Belvederi Murri, M.; Brakoulias, V.; Amore, M.; Ghaemi, S. N.; Amerio, A.. - In: JOURNAL OF AFFECTIVE DISORDERS. - ISSN 0165-0327. - 279:(2021), pp. 473-483. [10.1016/j.jad.2020.09.131]
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S0165032720328287-main.pdf

accesso aperto

Tipologia: Documento in Post-print
Licenza: Creative commons
Dimensione 1.13 MB
Formato Adobe PDF
1.13 MB Adobe PDF Visualizza/Apri
Costantini et al 2021.pdf

non disponibili

Tipologia: Versione (PDF) editoriale
Licenza: NON PUBBLICO - Accesso privato/ristretto
Dimensione 1.24 MB
Formato Adobe PDF
1.24 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2881953
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 309
  • ???jsp.display-item.citation.isi??? 281
social impact