title: The Patient Health Questionnaire depression screener in spinal cord injury.
abstract: Although depression is not inevitable following spinal cord injury/dysfunction (SCI/D), it can have a negative impact on rehabilitation. Evidence-based assessment of depression utilizing self-report instruments, such as the Patient Health Questionnaire-9 (PHQ-9), is considered good clinical practice. Although the PHQ-9 has been studied in individuals with SCI/D, little is known about the clinical utility of the Patient Health Questionnaire-2 (PHQ-2). Traditional cutoff scores for the PHQ-2 were examined to explore their operating characteristics as related to PHQ-9 results.
  
  
  
  Archival data were collected for 116 Veterans with SCI/D who completed the PHQ-2 and PHQ-9 as one component of their routine, comprehensive SCI annual evaluation at a Veterans Affairs Medical Center. Logistic regressions were performed to determine the impact of different cutoff scores for the PHQ-2 on the likelihood that participants would endorse clinically significant levels of depressive symptoms on the PHQ-9 (≥10).
  
  
  
  Using a cutoff score of 3 or greater correctly classified 94.8% of the cases, outperforming the other cutoff scores. A cutoff score of 3 or greater had a sensitivity of 83.3% and specificity of 97.8%, and yielded a positive predictive value of 90.9% and a negative predictive value of 95.7%.
  
  
  
  The PHQ-2 shows promise as a clinically useful screener in the community-residing SCI/D population. Findings regarding the presence of suicidal ideation emphasize the importance of routine screening for depressive symptomatology in the SCI/D population. Future research should investigate the role of the PHQ-2 in clinical decision-making and treatment monitoring.
authors.affiliation: a TIRR Memorial Hermann , Houston , Texas , USA.
authors.forename: Julia M P
authors.initials: JMP
authors.lastname: Poritz
authors.affiliation: b VISN 17 Center of Excellence for Research on Returning War Veterans , Waco , Texas , USA.|c Central Texas Veterans Health Care System , Temple , Texas , USA.|d Texas A&M College of Medicine , Temple , Texas , USA.
authors.forename: Joseph
authors.identifier: 0000-0001-8618-2607
authors.initials: J
authors.lastname: Mignogna
authors.affiliation: e Michael E. DeBakey VA Medical Center , Houston , Texas , USA.|f Baylor College of Medicine , Houston , Texas , USA.
authors.forename: Aimee J
authors.identifier: 0000-0003-2558-966X
authors.initials: AJ
authors.lastname: Christie
authors.affiliation: e Michael E. DeBakey VA Medical Center , Houston , Texas , USA.|f Baylor College of Medicine , Houston , Texas , USA.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Holmes
authors.affiliation: e Michael E. DeBakey VA Medical Center , Houston , Texas , USA.|f Baylor College of Medicine , Houston , Texas , USA.
authors.forename: Herb
authors.initials: H
authors.lastname: Ames
mesh_terms: D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D000073222:Patient Health Questionnaire / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data
keywords: Depression; Patient Health Questionnaire; Screening; Spinal cord injury