title: An efficient way to detect poststroke depression by subsequent administration of a 9-item and a 2-item Patient Health Questionnaire.
abstract: OBJECTIVE
  The early detection of poststroke depression is essential for optimizing recovery after stroke. A prospective study was conducted to investigate the diagnostic value of the 9-item and the 2-item Patient Health Questionnaire (PHQ-9, PHQ-2).
  
  
  METHODS
  One hundred seventy-one consecutive patients with stroke who could communicate adequately were included. In the 6th to 8th weeks after stroke, depression was measured using the PHQ-9 and PHQ-2 and diagnosed using the Composite International Diagnostic Interview.
  
  
  RESULTS
  Of the participating patients, 20 (12.2%) were depressed. The PHQ-9 performed best at a score ≥10, a sensitivity of 0.80 (95% CI, 0.62-0.98), and a specificity of 0.78 (95% CI, 0.72-0.85) and the PHQ-2 at a score ≥2 with a sensitivity of 0.75 (95% CI, 0.56-0.94) and a specificity of 0.76 (95% CI, 0.69-0.83). Administering the PHQ-9 only to patients who scored ≥2 on the PHQ-2 improved the identification of depression (sensitivity, 0.87; 95% CI, 0.69-1.04).
  
  
  CONCLUSIONS
  The diagnostic value is acceptable to good for PHQ-9 scores ≥10 and PHQ-2 scores ≥2. Conducting a PHQ-9 only in patients with a PHQ-2 score ≥2 generates the best results.
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Centre Utrecht, Utrecht, The Netherlands. J.M.deMan@umcutrecht.nl
authors.forename: Janneke M
authors.initials: JM
authors.lastname: de Man-van Ginkel
authors.forename: Thóra
authors.initials: T
authors.lastname: Hafsteinsdóttir
authors.forename: Eline
authors.initials: E
authors.lastname: Lindeman
authors.forename: Huibert
authors.initials: H
authors.lastname: Burger
authors.forename: Diederick
authors.initials: D
authors.lastname: Grobbee
authors.forename: Marieke
authors.initials: M
authors.lastname: Schuurmans
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D059445:Anhedonia / Q000502:physiology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult