PGY-3 St. Barnabas Hospital - Department of Pediatrics St Barnabas Hospital Bronx, New York, United States
Background: There has been an increase in depression among adolescents in the past decade, with around 20% of adolescents experiencing a major depressive disorder (MDD) by the time they reach 18 years old. Early detection is important due to the potential chronic nature of depression and its sequelae such as impaired social functioning and risk for suicidality. The 2-item and 9-item Patient Health Questionnaires (PHQ) are validated screening tools for depression in individuals 12 years of age and older. The PHQ-2 is used for screening while the PHQ-9 may be used to screen, diagnose, measure the severity of symptoms, and monitor response to intervention. Some studies found that while the PHQ-2 performed well, the PHQ-9 was superior in detecting depression. Other studies have compared the two tests among adults in the primary care setting; however, there are no recent studies that compare these tests in an urban adolescent population.
Objective: To compare the PHQ-2 with the PHQ-9 in detecting depression in an urban adolescent population.
Design/Methods: Cross-sectional study of adolescent subjects 12-18 years of age. All subjects completed the PHQ-2 and PHQ-9 questionnaires. Demographic data included age, gender, and ethnicity. Statistical analysis focused on the relationship between the two validated instruments in detecting depression.
Results: One hundred and forty-two subjects were included in the study. Participants were predominantly Hispanic (73.9%) and more than half were female (52.1%). Most of the subjects were mid to late adolescents, age 15-18 years. There was a significant difference in the overall scores of both PHQ-2 and PHQ-9 in females compared with males (P=0.00 and 0.001, respectively), with females scoring higher on both screening tools. On the PHQ-2, males scored an average of 0.6±92 and females scored an average of 1.31±1.57. On the PHQ-9, the average score among males was 2.74±3.21 and for females was 5.14±4.92. There was a high correlation between the two tests in detecting depression (P=<0.01) with cut-off points set at ≥3 for the PHQ-2 and ≥10 for the PHQ-9. There was no significant difference found between the two tests in relation to age or ethnicity. Conclusion(s): These data suggest that the PHQ-2 and PHQ-9 are effective screening tools in detecting depression among urban adolescents. Because adolescent girls scored higher for depression on both screening tools, future studies may investigate the use of different cut-offs for detection of depression in males and females taking the PHQ-2 and PHQ-9.
Authors/Institutions: Sarah Polistico, St Barnabas Hospital, Bronx, New York, United States; Janine Adjo, St Barnabas Hospital, Bronx, New York, United States; David H. Rubin, St Barnabas Hospital, Bronx, New York, United States
