A Brief Depression Screening Tool for Perinatal Clinical Practice : The Performance of the PHQ-2 Compared with the PHQ-9
© 2022 by the American College of Nurse-Midwives..
INTRODUCTION: There is ongoing interest in using brief screening instruments to identify perinatal depression in clinical practice. One ultra-brief screening instrument for depression is the Patient Health Questionnaire-2 (PHQ-2), but thus far its accuracy in perinatal clinical practice has been barely researched. In the present study, we aimed to assess the screening accuracy of the PHQ-2 against the Patient Health Questionnaire-9 (PHQ-9) in a large sample of perinatal women.
METHODS: A total of 1155 consecutive women attending 11 health care centers throughout Italy completed the PHQ-9 (which includes the PHQ-2) during pregnancy (27-40 weeks) or postpartum (1-13 weeks). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative, and overall accuracy were calculated using cut points 3 or greater and 2 or greater.
RESULTS: During pregnancy, PHQ-2 greater than or equal to 3 revealed low sensitivity (38.4%-44.7%) but high specificity (97.8%-99.3%). In postpartum, it revealed moderate sensitivity (56.9%-70.6%), high specificity (95.8%-99.8%), and fair overall accuracy in pregnancy (70%). The alternative threshold greater than or equal to 2 revealed very high sensitivity (pregnancy: 92.1%-95.2%; postpartum: 87.1%-95.2%), moderate specificity (pregnancy: 78.1%-83.2%; postpartum: 68.8%-81.1%) and good overall accuracy, both during pregnancy (87%) and postpartum (84%).
DISCUSSION: The PHQ-2 provided acceptable accuracy for screening for depression compared with the PHQ-9. In perinatal screening practice, a threshold of 2 or greater should be preferred as this ensures high sensitivity, missing only approximately 6% to 8% of cases, and a false-positive rate (percentage of women classified as affected with depressive symptoms when they are not) of 19% to 25%.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:67 |
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| Enthalten in: |
Journal of midwifery & women's health - 67(2022), 5 vom: 13. Sept., Seite 586-592 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gigantesco, Antonella [VerfasserIn] |
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| Anmerkungen: |
Date Completed 12.10.2022 Date Revised 20.11.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jmwh.13389 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342920391 |
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| 245 | 1 | 2 | |a A Brief Depression Screening Tool for Perinatal Clinical Practice |b The Performance of the PHQ-2 Compared with the PHQ-9 |
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| 500 | |a Date Revised 20.11.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 by the American College of Nurse-Midwives. | ||
| 520 | |a INTRODUCTION: There is ongoing interest in using brief screening instruments to identify perinatal depression in clinical practice. One ultra-brief screening instrument for depression is the Patient Health Questionnaire-2 (PHQ-2), but thus far its accuracy in perinatal clinical practice has been barely researched. In the present study, we aimed to assess the screening accuracy of the PHQ-2 against the Patient Health Questionnaire-9 (PHQ-9) in a large sample of perinatal women | ||
| 520 | |a METHODS: A total of 1155 consecutive women attending 11 health care centers throughout Italy completed the PHQ-9 (which includes the PHQ-2) during pregnancy (27-40 weeks) or postpartum (1-13 weeks). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative, and overall accuracy were calculated using cut points 3 or greater and 2 or greater | ||
| 520 | |a RESULTS: During pregnancy, PHQ-2 greater than or equal to 3 revealed low sensitivity (38.4%-44.7%) but high specificity (97.8%-99.3%). In postpartum, it revealed moderate sensitivity (56.9%-70.6%), high specificity (95.8%-99.8%), and fair overall accuracy in pregnancy (70%). The alternative threshold greater than or equal to 2 revealed very high sensitivity (pregnancy: 92.1%-95.2%; postpartum: 87.1%-95.2%), moderate specificity (pregnancy: 78.1%-83.2%; postpartum: 68.8%-81.1%) and good overall accuracy, both during pregnancy (87%) and postpartum (84%) | ||
| 520 | |a DISCUSSION: The PHQ-2 provided acceptable accuracy for screening for depression compared with the PHQ-9. In perinatal screening practice, a threshold of 2 or greater should be preferred as this ensures high sensitivity, missing only approximately 6% to 8% of cases, and a false-positive rate (percentage of women classified as affected with depressive symptoms when they are not) of 19% to 25% | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Palumbo, Gabriella |e verfasserin |4 aut | |
| 700 | 1 | |a Cena, Loredana |e verfasserin |4 aut | |
| 700 | 1 | |a Camoni, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Trainini, Alice |e verfasserin |4 aut | |
| 700 | 1 | |a Stefana, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Mirabella, Fiorino |e verfasserin |4 aut | |
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