Q&A: Using the Patient Health Questionnaire-9 to screen patients for depression

Q: Do you have any advice or tools for screening patients for depression?

A: Depression is often an undiagnosed and untreated condition. Systematic screening in primary care offices or other clinical areas is recommended along with subsequent treatment and follow-up (DeJesus, Vickers, Melin, & Williams, 2007). The case manager or other healthcare professional may administer the simple and effective Patient Health Questionnaire (PHQ-9) with proven validity and reliability.

The PHQ-9 is a self-administered version of the depression module in the PRIME-MD diagnostic instrument for common mental disorders (Kroenke, Spitzer, & Williams, 2001). The PHQ-9 is used to monitor a patient’s severity of depression; however, it can also be used to make a tentative diagnosis of depression in patients with chronic disease such as stroke or coronary heart disease (Haddad et al., 2013; de Man-van Ginkel et al., 2012). The questionnaire is simple to use and can be self-administered or administered by the case manager. The case manager may administer the PHQ-9 in person or over the phone, allowing additional flexibility and accessibility to the patient. The copyright was originally held by Pfizer, who provided the grant for the research for PHQ-9. This is no longer in effect, so the case manager may reproduce and distribute the tool.

The primary care physician may use PHQ-9 to diagnose and treat depression. The PHQ-9 consists of 10 questions, and the score is an excellent outcome measure demonstrating the practitioner’s original diagnoses and through retesting and monitoring, a measure of a patient’s progress and improvement over time. As with any tool, it is not a substitute for clinical judgment.

For more information, see Case Management Guide to Population Health. Need expert advice? Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.