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  Publication Details

Title:
   Screening for Depression Using the PHQ-2: Changes over Time in Conjunction with Mental Health Treatment
Product type:
   Working Paper 14002
MEPS component:
   Household Component
Publication date:
   November 13, 2014
Description:
   Objective: The two-item Patient Health Questionnaire (PHQ-2) meets the criteria for general screening of depression suggested by the U.S. Preventive Services Task Force. This study examined changes in the PHQ-2 over time, stratifying by receipt of mental health treatment, to help interpret screening results.

Methods: We used nationally representative samples of the U.S. civilian, noninstitutionalized population from the 2004-2006 panels of the Medical Expenditure Panel Study. Adult respondents (n=23,770) completed the PHQ-2 twice, 10 months apart. Purchase of antidepressant medication and receipt of ambulatory mental health care were assessed for two four-month periods preceding PHQ-2 administrations. We categorized respondents as above or below the PHQ-2 threshold for probable depression and as receiving or not receiving mental health treatment. We examined changes in combined depression-treatment status over time using multinomial logistic regression.

Results: At each time point, 83 percent scored below PHQ-2 depression threshold and had no mental health treatment; 8 percent scored below the threshold and reported some mental health treatment; 6% were above threshold but had no treatment, and 3 percent were above threshold and received some mental health treatment. Eighty-five percent remained in the same depression-treatment combination over time. In multivariate analysis, the strongest predictor of depression-treatment status at time 2 was status at time 1. Fifty-seven percent of those depressed and without treatment at Time 1 were not depressed at Time 2.

Conclusions: The PHQ-2 is useful as a depression screener, with prevalence rates comparable to diagnostic interviews. The high proportion of remission without treatment complicates interpretation.
Author(s):
   John A. Fleishman and Samuel H. Zuvekas and Harold A. Pincus
Agency:
   Rockville (MD): Agency for Healthcare Research and Quality
Source:
   Web Only
MEPS Topics:
   Mental Health
PDF link:
   data_files/publications/workingpapers/wp_14002.pdf (2.8 MB)
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