Early identification of treatment non-response utilizing the Patient Health Questionnaire (PHQ-9)

J Christopher Fowler; Michelle Patriquin; Alok Madan; Jon G Allen; B Christopher Frueh; John M Oldham

doi:10.1016/j.jpsychires.2015.06.018

Early identification of treatment non-response utilizing the Patient Health Questionnaire (PHQ-9)

J Psychiatr Res. 2015 Sep:68:114-9. doi: 10.1016/j.jpsychires.2015.06.018. Epub 2015 Jun 25.

Authors

J Christopher Fowler¹, Michelle Patriquin², Alok Madan², Jon G Allen², B Christopher Frueh³, John M Oldham²

Affiliations

¹ The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. Electronic address: cfowler@menninger.edu.
² The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
³ The Menninger Clinic, 12301 Main Street Houston, TX 77035, USA; University of Hawaii, Department of Psychology, 200 West Kawili St., Hilo, HI 96720, USA.

PMID: 26228409
DOI: 10.1016/j.jpsychires.2015.06.018

Abstract

Background: Treatment non-response among high-risk, psychiatric patients exposes those suffering to suicidal risk as well as persistent social and occupational difficulties. Strategies for identification of treatment non-response are limited.

Aims: Diagnostic efficiency of a self-report, cross-cutting symptom measure was assessed as a marker of treatment non-response.

Method: 835 inpatients at a specialist psychiatric hospital completed the Patient Health Questionnaire - Depression (PHQ-9) at admission and every two weeks during hospitalization.

Results: For patients admitted with severe depression (PHQ-9 ≥ 20), results indicated good accuracy of 2-week PHQ-9 change score in identifying treatment non-response (AUC = 0.80, SE = 0.04, p < .0001; sensitivity = 85%; specificity = 73%; OR = 14.91).

Conclusions: The search for predictors of non-response to psychiatric treatment has a long and generally unfulfilled history. The PHQ-9 change score holds promise as a cost-effective test with comparable diagnostic characteristics to other medical tests.

Keywords: Diagnostic efficiency; PHQ-9; Prediction; Treatment non-response.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Early Diagnosis*
Female
Humans
Male
Mental Disorders / diagnosis*
Middle Aged
Predictive Value of Tests
Psychiatric Status Rating Scales
ROC Curve
Retrospective Studies
Self Report
Surveys and Questionnaires*
Young Adult