Two item screen for depression in adolescents

January 01, 0001

Two item screen for depression in adolescents

Depression is a significant problem in primary care, and adolescent patients are both at risk for depression and can present diagnostic challenges. These US researchers tested whether the Patient Health Questionnaire 2 (PHQ-2), a two item patient self reporting tool, was valid for screening for depression in adolescents in primary care settings. They enrolled 444 patients aged 13-17 were enrolled and underwent assessment including the PHQ-2 and other psychiatric assessment and screening tools.

The researchers report: "A PHQ-2 score of 3 had a sensitivity of 74 percent and specificity of 75 percent for detecting youth who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for major depression on the Diagnostic Interview Schedule for Children and a sensitivity of 96 percent and specificity of 82 percent for detecting youth who met criteria for probable major depression on the Patient Health Questionnaire 9- item depression screen. On receiver operating characteristic analysis, the PHQ- 2 had an area under the curve of 0.84, and a cut point of 3 was optimal for maximizing sensitivity without loss of specificity for detecting major depression. Youth with a PHQ-2 score of 3 had significantly higher functional- impairment scores and significantly higher scores for parent-reported internalizing problems than youth with scores of less than 3."

The researchers concluded: "The PHQ-2 has good sensitivity and specificity for detecting major depression. These properties, coupled with the brief nature of the instrument, make this tool promising as a first step for screening for adolescent depression in primary care."

The PHQ-2 appears to be a promising screening tool for depression

For the full abstract, click here.

Pediatrics 125(5):e1097-e1103, May 2010
© 2010 American Academy of Pediatrics
Evaluation of the PHQ-2 as a Brief Screen for Detecting Major Depression Among Adolescents. Laura P. Richardson, Carol Rockhill, Joan E. Russo, et al.

Category: P. Psychological. Keywords: depression, screening, adolescence, primary care, PHQ-2, validation study screen, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 6 July 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.