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. 2010 Jun;60(575):e231-8.
doi: 10.3399/bjgp10X502119.

Concordance between PHQ-9 scores and patients' experiences of depression: a mixed methods study

Alice Malpass  1 , Alison Shaw, David Kessler, Deborah Sharp
Affiliations

Concordance between PHQ-9 scores and patients' experiences of depression: a mixed methods study

Alice Malpass et al. Br J Gen Pract. 2010 Jun.

Abstract

Background: In 2009, a new indicator (DEP 3) was introduced into the Quality and Outcomes Framework. GPs are now encouraged to assess response to antidepressant treatment 5-12 weeks after the initial assessment, to guide clinical decision making. The Patient Health Questionnaire (PHQ-9) is one of the validated instruments that GPs can use to assess the patient's clinical state.

Aims: To explore the extent to which changes in PHQ-9 score over time reflect patients' accounts of their experiences of depression during the same period; and to explore patients' experiences of using the PHQ-9 within primary care consultations.

Design of study: Mixed methods.

Setting: Primary care.

Method: Patients were recruited through six GP practices. The PHQ-9 and in-depth interviews were used at the same three time points over a 6-month period during a new or first episode of depression.

Results: Patterns in the total PHQ-9 score broadly reflected patients' accounts of the severity of their depression over time. However, the PHQ-9 was inaccurate in its assessment of the presence and intensity of thoughts of self-harm, and missed symptoms that are meaningful to patients. At the diagnostic primary care consultation, patients viewed their score as a 'tangible' measure of their condition. Some patients requested the PHQ-9 subsequently as a way to measure their own treatment response and recovery process.

Conclusion: The potential therapeutic value of the PHQ-9 may be dependent upon the GP's willingness to openly discuss the results and what they may mean for the patient.

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Comment in

  • PHQ-9: sensitivity to change over time.
    Cameron IM, Reid IC, Lawton K. Cameron IM, et al. Br J Gen Pract. 2010 Jul;60(576):535-6. doi: 10.3399/bjgp10X514909. Br J Gen Pract. 2010. PMID: 20594450 Free PMC article. No abstract available.

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