Validity of the Patient Health Questionnaire-9 in assessing depression following traumatic brain injury.
OBJECTIVE
To test the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) for diagnosing major depressive disorder (MDD) among persons with traumatic brain injury (TBI).


METHODS
Prospective cohort study.


METHODS
Level I trauma center.


METHODS
135 adults within 1 year of complicated mild, moderate, or severe TBI.


METHODS
PHQ-9 Depression Scale, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID).


RESULTS
Using a screening criterion of at least 5 PHQ-9 symptoms present at least several days over the last 2 weeks (with one being depressed mood or anhedonia) maximizes sensitivity (0.93) and specificity (0.89) while providing a positive predictive value of 0.63 and a negative predictive value of 0.99 when compared to SCID diagnosis of MDD. Pearson's correlation between the PHQ-9 scores and other depression measures was 0.90 with the Hopkins Symptom Checklist depression subscale and 0.78 with the Hamilton Rating Scale for Depression. Test-retest reliability of the PHQ-9 was r = 0.76 and kappa = 0.46 when using the optimal screening method.


CONCLUSIONS
The PHQ-9 is a valid and reliable screening tool for detecting MDD in persons with TBI.
Fann
Jesse R
JR
Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle 98195, USA. fann@u.Washington.edu
Bombardier
Charles H
CH
Dikmen
Sureyya
S
Esselman
Peter
P
Warms
Catherine A
CA
Pelzer
Erika
E
Rau
Holly
H
Temkin
Nancy
N
D000328:Adult; D017677:Age Distribution; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires