Remember: these self-assessments are for screening … PATIENT HEALTH QUESTIONNAIRE-9 (PHQ-9) Over the last 2 weeks, how often have you been bothered by any of the following problems? Depression and medical illness. When screening for depression the Patient Health Questionnaire (PHQ-2) can be used first (it has a 97% sensitivity and a 67% specificity). Not at all0. PHQ-9 score ≥10 had a sensitivity of 88% and a specificity of 88% for major depression. The link between depression and physical symptoms. TOOL 1. Primary Care Companion Journal of Clinical Psychiatry, 6(suppl 1), 12–16. Edinburgh Postnatal Depression Scale (EDPS), http://www.nimh.nih.gov/health/publications/depression/index.shtml?rf=3247, http://www.cdc.gov/nchs/fastats/depression.htm, https://www.healthquality.va.gov/guidelines/MH/mdd/VADoDMDDCPGFINAL82916... (link is external), http://www.ncbi.nlm.nih.gov/books/NBK63748/. Stewart, T., Yusim, A., & Desan, P. (2005). Description: The screening tools are used to help primary care provider screen patients for mental health disorders.Screening tools are available in different languages and are downloadable PHQ-9 screens for Major Depressive Disorder GAD-7 screens for Generalized Anxiety Disorder Retrieved from https://www.healthquality.va.gov/guidelines/MH/mdd/VADoDMDDCPGFINAL82916... (link is external). Gadermann, A.M., Engel, C.C., Naief, J.A., Nock, M.K., Petukhova, M., Santiago, P.N., Benjamin, W., Zaslavasky, A.M., & Kessler, R. (2012). See if you are eligible for a free NHS flu jab today. [ Reference 12 ], *adapted from the VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder (2016). Its items are drawn from the first two items of the 'Generalized Anxiety Disorder–7 scale' (GAD–7) and the 'Patient Health Questionnaire-8' (PHQ-8). [2], It is not a screening tool for depression but it is used to monitor the severity of depression and response to treatment. Bethesda, MD: U.S. Government Printing Office. http://iom.nationalacademies.org/Reports/2014/Preventing-Psychological-D... https://www.healthquality.va.gov/guidelines/MH/mdd/MDDTool4Depression4x6... Behavioral Health Technicians in the Military, Clinical Practice Guidelines and Clinical Support Tools, Disclosure of Protected Health Information, Evidence Synthesis & Research Gaps Analysis, Department of Defense Suicide Event Report (DoDSER), dha.ncr.j-9.mbx.phcoe-contact-us@mail.mil, Patient with suspected depression identified based on positive screen on PHQ-2 or clinical suspicion. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. All rights reserved. [ Reference 2 ], Current guidelines for VA and DoD recommend annual screening for depression, with more frequent screening for several high-risk populations, such as those with congestive heart failure, significant losses, and chronic medical illness, or pregnant or postpartum women. Providers should complete assessment for acute safety risks (e.g., harm to self or others, psychotic features, etc.) Depression (NIH Publication No. Retrieved from http://iom.nationalacademies.org/Reports/2014/Preventing-Psychological-D.... Department of Veterans Affairs/Department of Defense. [1] The PHQ-9 is the depression module, which scores each of the nine DSM-IV criteria as "0" (not at all) to "3" (nearly every day). Darunavir-Cobicistat-Tenofovir alafenamide-Emtricitabine Symtuza. The copyright for the PHQ-9 was formerly held with Pfizer, who provided the educational grant for Drs Spitzer, Williams and Kroenke who originally designed it. In I. H. Gotlib & C. L. Hammen (Eds. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD tool for common mental health disorders administered by health care professionals. Major depressive disorder frequently occurs with other psychiatric disorders, including substance-related disorders, panic disorder, obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, and borderline personality disorder. Diagnostic and statistical manual of mental disorders (5th ed.). VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder. Washington DC: National Academies Press. No matter what your score is, you should seek help if you have any concerns about yourself or your loved ones. Prevalence of DSM-IV major depression among U.S. military personnel: Meta-analysis and simulation. NIMH causes of depression. Suite 5101 They are written by UK doctors and based on research evidence, UK and European Guidelines, so you may find the language more technical than the condition leaflets. 31 First validated in 1999, several follow-up studies have continued to support its validity in outpatient adult settings, both as an initial screening tool as well as a follow-up instrument to monitor treatment response. (2014). However, it can be used to make a tentative diagnosis of depression in at-risk populations - eg, those with coronary heart disease or after stroke. (2006). The PHQ is 59-question instrument. However, no test is 100% accurate. Screening Tool: Depression (in Adults) (9-item PHQ-9) This survey is designed to provide a quick assessment of whether you might have signs and symptoms related to depression. VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder (PHQ-2), The PHQ-2 is a two-item self-report that inquires about the frequency of depressed mood and anhedonia over the last two weeks. The PHQ-9 is the depression module, which scores each of the nine DSM-IV criteria as "0" (not at all) to "3" (nearly every day). (2015). (Use “ ” to indicate your answer) Not at all Several (2004). [ Reference 7 ] All patients not currently receiving treatment for depression should be screened for depression using this tool. The PHQ-9 consists of nine questions and scores each of the nine DSM-IV criteria based on the frequency of symptom. Patients who screen positive (score ≥3) should be further assessed. Its purpose is to allow for very brief and accurate measurement of depression and anxiety. ), Handbook of depression, second edition (pp. The Patient Health Questionnaire-2 (PHQ-2) Kroenke K, Spitzer RL, Williams JB. Arlington, VA: American Psychiatric Publishing. Falls Church, VA 22041, Phone: 301-295-7692 3. Journal of the American Medical Association Psychiatry, 71(5), 504-513. [ Reference 9 ] It should not, though, be used in isolation to make a diagnosis without considering other aspects of the assessment, such as whether the symptoms may be better accounted for by another disorder (e.g., PTSD, hypothyroidism, etc.). © Patient Platform Limited. [ Reference 11 ] The PHQ-9 should be used at least monthly to track progress, particularly as systematic measurement of treatment response has been found to increase the likelihood of response to treatment. or assessment tool? Our clinical information is certified to meet NHS England's Information Standard.Read more. Scoring notes. Military Medicine, 177(8), 47-59. 113-141). Screening is a component of integrated care programs that are effective models for managing these patients in primary care settings. Subscribe to our news and information outlining our efforts to advance excellence in psychological health care in the Military Health System. The PHQ is a self-administered version of the PRIME-MD, a screening tool that assesses 12 mental and emotional health disorders. For patients with a diagnosis of MDD, the PHQ-9 can be used as a quantitative measure of depression severity in the initial treatment planning and to monitor treatment progress. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. These conditions may include cardiovascular diseases, chronic pain syndrome, degenerative disorders, immune disorders, metabolic endocrine conditions, neoplasms, or trauma. Use of the PHQ-9 alone does not replace the need for a clinical interview and full assessment to establish a diagnosis of MDD. It is readily available in the VA and DoD and takes as little as two minutes to complete. PHQ-9* Questionnaire for Depression Scoring and Interpretation Guide For physician use only Scoring: Count the number (#) of boxes checked in a column. & Carney, R.M. Hoge, C.W., Auchterlonie, J.L., & Milliken C.S. Depression. Women that are pregnant or postpartum are at elevated risk for depression and if untreated, this depression can have adverse impacts on mother and child. Feeling bad about yourself - or that you are a failure or have let yourself or your family down? It has been validated for use in primary care. The PHQ-2 inquires about the frequency of depressed mood, with a score ranging from 0 to 6. [ Reference 10 ]  Providers should review a patient’s response to the last item (“Thoughts that you would be better off dead or of hurting yourself in some way?”), as it has been associated with increased risk for a suicide attempt. During the past month, have you often been bothered by feeling down, depressed, or hopeless 2. Psychological Medicine, 41(10), 2035–2045. Depression as a risk factor for cardiovascular disease. tool and an assessment tool. (2013). 2. Screening and follow-up of a positive screen should be standard clinical practice. Hoge, C.W., Castro, C.A., Messer, S.C., McGurk, D., Cotting, D.I., Koffman, R.L. PHQ-9 Depression Severity Scores represent: 0-5 = mild 6-10 = moderate 11-15 = moderately severe 16-20 = severe depression GAD-7 Anxiety Severity. The Patient Health Questionnaire (PHQ) tools are designed to facilitate recognition and diagnosis of depression in primary care patients. Psychological Health Center of Excellence (PHCoE), 7700 Arlington Blvd They can also be found in the VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder. Little interest or pleasure in doing things? The PHQ-2 has sensitivity comparable with the PHQ-9 … The two-item and nine-item Patient Health Questionnaires (PHQs) are commonly used validated screening tools. Background and purpose: The purpose of this study was to examine the performance of the Patient Health Questionnaire (PHQ)-9, a 9-item depression scale, as a screening and diagnostic instrument for assessing depression in stroke survivors. Robert L. Spitzer, Janet W.B. The PHQ-9 is the 9-question depression scale of PHQ. [1] This is no longer the case and no permission is required to reproduce, translate, display or distribute the PHQ-9. Nearly every day+3. (2004). The PHQ-9 is the 9-item depression module from the full The Patient Health Questionnaire (PHQ which is designed to be entirely self-administered by a patient.. Over the past 2 weeks, how often have you been bothered by any of the following problems? Preventing psychological disorders in service members and their families. Patient does not provide medical advice, diagnosis or treatment. PHQ-9 QUICK DEPRESSION ASSESSMENT For initial diagnosis: 1. It is the dedication of healthcare workers that will lead us through this crisis. (2015). This is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of “not at all,” Depression: The treatment and management of depression in adults (Updated Edition). www.PDHealth.mil is the Official Website of the Psychological Health Center of Excellence (PHCoE), (formerly Deployment Health Clinical Center), Psychological Health Center of Excellence. [ Reference 8 ], VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder (PHQ-9), The PHQ-9 is a validated, nine-item questionnaire that can be self- or interviewer- administered to screen for the presence of depressive symptoms and symptom severity within the previous two weeks. They incorporate DSM-IV depression criteria with other leading major depressive symptoms into a brief self-report instruments that are commonly used for screening and diagnosis, as well as selecting and monitoring treatment. Understanding Depression: A Resource for Providers and Patients. Psychological conditions that may complicate treatment or put an individual at increased risk for adverse outcomes are bipolar disorder, posttraumatic stress disorder (PTSD), substance use disorder (SUD), suicidality or homicidality, and psychosis. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. Previous meta-analyses on diagnostic test accuracy of PHQ-9 have had limitations including selective cut-off reporting in primary studies and inability to assess differences across patient subgroups American Psychiatric Association. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. [ Reference 3 ] There are several validated instruments for the screening of depression, though the Patient Health Questionnaire-2 (PHQ-2) is widely used and recommended within the VA and DoD. Single-Tablet Regimens. (2008). The Patient Health Questionnaire (PHQ) is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression, anxiety, alcohol, eating, and somatoform disorders. PHQ (2 Question Screen) Name:_____ Date:_____ Over the last 2 weeks, how often have you been bothered by any of the following problems? [ Reference 5 ] The PHQ-2 is the recommended screening tool and patients who screen positive on the PHQ-2 should be provided further assessment of symptoms and risk. New York, NY: Guilford Press. The Patient Health Questionnaire (PHQ) tools are designed to facilitate recognition and diagnosis of depression in primary care patients. Over the last two weeks, how often have you been bothered by any of the following problems? Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. The PHQ-9 and GAD-7 are designed to facilitate the recognition for depressive disorders and anxiety disorders respectively. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. The tools are intended to educate and are not designed to provide a clinical diagnosis. Time to administer: Approximately 2-5 minutes: Versions: The PHQ-9 was developed by Drs. If there are at least 4 s in the blue highlighted section (including Questions #1 and #2), consider a depressive disorder. It has been validated for use in primary care. Professional Reference articles are designed for health professionals to use. The PHQ-9 (Patient Health Questionnaire-9) objectifies and assesses degree of depression severity via questionnaire. National Institute of Mental Health (NIMH). Institute of Medicine. For details see our conditions. More research is needed to support the PHQ-15 as a measure of responsiveness to changes throughout treatment of individuals with somatoform disorders (Kroenke et al., 2010). Chapman, D.P., Whitfield, C.L., Felitti, V.J., Dube, S.R., Edwards, V.J., & Anda, R.F. Kendler, K.S. (2004). The PHQ-9 has been referred to as both a screening Testing for disease in people without symptoms. Patient completes PHQ-9 Quick Depression Assessment on accompanying tear-off pad. Retrieved from http://www.cdc.gov/nchs/fastats/depression.htm (link is external). Thoughts that you would be better off dead, or of hurting yourself in some way? Depressive symptoms that require immediate attention, to include referral to emergency services or consultation with a mental health care provider: Serious delusions (e.g., fixed false beliefs), Visual or (typically) auditory hallucinations, Catatonic behavior (e.g., motoric immobility or excessive agitation), Inappropriate affect of a bizarre or odd quality. National Collaborating Centre for Mental Health (UK). The Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used and validated screening tools. Box #22 (Silver Spring Office) Trivedi, M.H. The possible range is 0-27. Email:dha.ncr.j-9.mbx.phcoe-contact-us@mail.mil. While the PHQ-2 is used as a screening tool for depression, the PHQ-9 can be used to obtain information on depression severity or response to treatment for patients with a depressive disorder. The 'Patient Health Questionnaire-4' (PHQ-4) is a 4 item inventory rated on a 4 point Likert-type scale. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK63748/. Human services, and attrition from military service after returning from deployment to Iraq or Afghanistan in Iraq Afghanistan... That are effective models for managing these patients in primary care Companion journal of PHQ-9! Last two weeks, how often have you been bothered by feeling down,,! 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