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  3. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis
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Research

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1476 (Published 09 April 2019) Cite this as: BMJ 2019;365:l1476

Linked opinion

The accuracy of the Patient Health Questionnaire-9 for detecting major depression

Linked opinion

Screening tools offer value when combined with an informed shared decision process

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Re: Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

I am very concerned by the use of the PHQ9 questionnaire to assess the effect of interventions such as CBT on people who are depressed. I consider this a misuse as it has not been validated in this situation, though it seems to be common.
I also think that there has been little or no research to find the effect of using it repeatedly with an individual in other circumstances
Some of the questions are cumbersome and totally inappropriate for people with neuro-developmental differences, in particular autism spectrum conditions.
As a GP I had to complete a PHQ9 with any patient I was referring for IAPT.
Another concern is that it tends to mitigate against asking important questions to assess risk of a patient taking their life, as the last question actually makes this feel a bit tautological, while not asking with sufficient clarity on these questions.
I think it is fine as a screening tool, but inappropriate in other situations, for which it is regularly used.
I would value your opinion on this.

Competing interests: No competing interests

19 April 2019
Karen E Upton
Clinical lead children, autism and learning disabilities and safeguarding (retired GP)
London
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