An Efficient Way to Detect Poststroke Depression by Subsequent Administration of a 9-Item and a 2-Item Patient Health Questionnaire
Background and Purpose—The early detection of poststroke depression is essential for optimizing recovery after stroke. A prospective study was conducted to investigate the diagnostic value of the 9-item and the 2-item Patient Health Questionnaire (PHQ-9, PHQ-2).
Methods—One hundred seventy-one consecutive patients with stroke who could communicate adequately were included. In the 6th to 8th weeks after stroke, depression was measured using the PHQ-9 and PHQ-2 and diagnosed using the Composite International Diagnostic Interview.
Results—Of the participating patients, 20 (12.2%) were depressed. The PHQ-9 performed best at a score ≥10, a sensitivity of 0.80 (95% CI, 0.62–0.98), and a specificity of 0.78 (95% CI, 0.72–0.85) and the PHQ-2 at a score ≥2 with a sensitivity of 0.75 (95% CI, 0.56–0.94) and a specificity of 0.76 (95% CI, 0.69–0.83). Administering the PHQ-9 only to patients who scored ≥2 on the PHQ-2 improved the identification of depression (sensitivity, 0.87; 95% CI, 0.69–1.04).
Conclusions—The diagnostic value is acceptable to good for PHQ-9 scores ≥10 and PHQ-2 scores ≥2. Conducting a PHQ-9 only in patients with a PHQ-2 score ≥2 generates the best results.
- Received October 4, 2011.
- Accepted October 20, 2011.
- © 2011 American Heart Association, Inc.