title: Clinic-based depression screening in lung cancer patients using the PHQ-2 and PHQ-9 depression questionnaires: a pilot study.
abstract: OBJECTIVE
  This study aims to validate the ability to perform depression screening with the patient health questionnaire (PHQ)-2 and PHQ-9 depression modules in a busy, outpatient practice, and to evaluate the prevalence of depression among lung cancer outpatients at our institution.
  
  
  METHODS
  In 2010, 64 patients in a thoracic malignancy clinic completed the Patient Health Questionnaire-2. Patients endorsing either one or both items were then given the Patient Health Questionnaire-9, a nine-item depression assessment tool. Patients with mild or worse depression were offered a referral to a mental health care provider.
  
  
  RESULTS
  Eighteen of 64 patients (28 %) endorsed one or both items on the PHQ-2. Thirteen of 18 patients with a positive PHQ-2 screen completed the PHQ-9, with mean score of 10.2 (SD 3.91), suggesting moderate depression. PHQ-9 item 4, evaluating fatigue, was positive in 12 patients, and PHQ-9 item 9, evaluating suicidal ideation, was never reported. Only 1 of 18 patients with a positive PHQ-2 screen was being followed by a psychiatrist, and no patient accepted a new referral to a mental health provider.
  
  
  CONCLUSIONS
  The PHQ-2 and PHQ-9 modules are an effective means of depression screening in a busy, outpatient clinic. A high prevalence of depression was reported; yet, suicidal ideation was not reported. Depression severity ranged from mild to severe. The most endorsed PHQ-9 item was fatigue, although it is uncertain if this reflects a symptom of depression, a sequela of lung cancer itself, or both. The lung cancer patients in this sample who reported depression were unlikely to receive mental health services.
authors: Department of Medicine, Moores Cancer Center, University of California, San Diego, La Jolla, San Diego, CA 92093, USA. jrandall@ucsd.edu
authors: J Michael
authors: JM
authors: Randall
authors: Rochelle
authors: R
authors: Voth
authors: Erin
authors: E
authors: Burnett
authors: Lyudmila
authors: L
authors: Bazhenova
authors: Wayne A
authors: WA
authors: Bardwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D015995:Prevalence; D012017:Referral and Consultation; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires