Reassessing the clinical utility of the Patient Health Questionnaire (PHQ)-9 for depression screening in prenatal women: a commentary on Sidebottom et al.

Excerpt

Sidebottom et al. (2012) evaluated the accuracy of the Patient Health Questionnaire-9 (PHQ-9) to identify pregnant women with depression. They studied 745 women from three community health centers who completed the PHQ-9 and were assessed for depressive disorders with the Structured Clinical Interview for DSM-IV. The prevalence of current major depressive disorder (MDD) was 3.6 % (n = 27). A PHQ-9 cutoff score of ≥10 was 85 % sensitive and 84 % specific for identifying women with MDD. The positive predictive value (PPV), which is the percent of women with positive depression screens who had MDD, was 17 %, which increased to 43 % if women with three or more symptoms of depression, but who did not meet criteria for MDD, were additionally counted as cases. Sidebottom et al. concluded that the PHQ-9 would be useful for screening to identify pregnant women with MDD. Implementation of this recommendation would be certain to consume substantial resources, but may not result in improved mental health for pregnant women. …