2-Question Patient Health Questionnaire (PHQ-2) May Help Detect Major Depression in Adolescents

DynaMed Weekly Update - Volume 5, Issue 16

The United States Preventive Services Task Force (USPSTF) recommends (Grade B Recommendation) depression screening in adolescents aged 12-18 years when systems for diagnosis, treatment, and follow-up are in place (Pediatrics 2009 Apr;123(4):122), but screening can be time-consuming. The PHQ-2, which includes 2 questions from the 9-question PHQ-9, is a commonly used and highly sensitive instrument in adults and elderly patients (J Am Geriatr Soc 2007 Apr;55(4):596). A recent cohort study with 2,291 patients aged 13-17 years suggests that it can also be helpful as an initial screening tool in adolescents (level 2 [mid-level] evidence). Patients were asked how often in the last 2 weeks they had experienced a depressed mood and lack of pleasure in usual activities. The score on each question ranged from 0 for not at all to 3 for nearly every day. A total score of ? 3, which was considered positive for depression, was found in 12%. A subgroup of 271 screened-positive and 228 screened-negative adolescents completed formal diagnostic interviews, and 19 participants met DSM-IV criteria for major depression. The PHQ-2 with a cutoff value of 3 points had 74%sensitivity, 75% specificity, 12% positive predictive value, and 99% negative predictive value for major depression (Pediatrics. 2010 May;125(5):e1097).

For more information, see the Depression topic in DynaMed.

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