Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study.
OBJECTIVE
This study was undertaken to determine the prevalence of mental disorders among obstetric-gynecologic patients and to assess the validity and utility of the PRIME-MD Patient Health Questionnaire (PHQ) in this population.


METHODS
A total of 3000 patients were assessed by 63 clinicians at seven obstetrics-gynecology outpatient care sites. The main outcome measures were PRIME-MD PHQ diagnoses, psychosocial stressors, independent diagnoses made by mental health professionals, functional status measures, disability days, health care use, and treatment or referral decisions.


RESULTS
Current mental disorders were fairly prevalent, present in 1 in 5 obstetric-gynecologic patients. Patients with PRIME-MD PHQ diagnoses had more functional impairment, disability days, health care use, and psychosocial stressors than did patients without PRIME-MD PHQ diagnoses (P <.005 for all measures). Although most clinicians judged the PRIME-MD PHQ to be useful in management decisions, the questionnaire diagnosis of mental disorder rarely led to therapeutic intervention.


CONCLUSIONS
The PRIME-MD PHQ is a useful instrument for the assessment of mental disorders, functional impairment, and recent psychosocial stressors in the busy obstetrics-gynecology setting.
Spitzer
R L
RL
Biometrics Research Department, New York State Psychiatric Institute, New York, NY 10032, USA. rls8@columbia.edu
Williams
J B
JB
Kroenke
K
K
Hornyak
R
R
McMurray
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006176:Gynecology; D006801:Humans; D008598:Menstruation; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D009774:Obstetrics; D011247:Pregnancy; D011293:Premenstrual Syndrome / Q000453:epidemiology; D012098:Reproduction; D013315:Stress, Psychological; D011795:Surveys and Questionnaires