title: Early identification of treatment non-response utilizing the Patient Health Questionnaire (PHQ-9).
abstract: BACKGROUND
  Treatment non-response among high-risk, psychiatric patients exposes those suffering to suicidal risk as well as persistent social and occupational difficulties. Strategies for identification of treatment non-response are limited.
  
  
  OBJECTIVE
  Diagnostic efficiency of a self-report, cross-cutting symptom measure was assessed as a marker of treatment non-response.
  
  
  METHODS
  835 inpatients at a specialist psychiatric hospital completed the Patient Health Questionnaire - Depression (PHQ-9) at admission and every two weeks during hospitalization.
  
  
  RESULTS
  For patients admitted with severe depression (PHQ-9 ≥ 20), results indicated good accuracy of 2-week PHQ-9 change score in identifying treatment non-response (AUC = 0.80, SE = 0.04, p < .0001; sensitivity = 85%; specificity = 73%; OR = 14.91).
  
  
  CONCLUSIONS
  The search for predictors of non-response to psychiatric treatment has a long and generally unfulfilled history. The PHQ-9 change score holds promise as a cost-effective test with comparable diagnostic characteristics to other medical tests.
authors.affiliation: The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Electronic address: cfowler@menninger.edu.
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Fowler
authors.affiliation: The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Patriquin
authors.affiliation: The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.affiliation: The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: Jon G
authors.initials: JG
authors.lastname: Allen
authors.affiliation: The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; University of Hawaii, Department of Psychology, 200 West Kawili St., Hilo, HI 96720, USA.
authors.forename: B Christopher
authors.initials: BC
authors.lastname: Frueh
authors.affiliation: The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Oldham
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Diagnostic efficiency; PHQ-9; Prediction; Treatment non-response