The Usefulness of the 9-item Patient Health Questionnaire (PHQ-9) to Screen Major Depression for Patients on a Palliative Care Unit: A Case That without No Regular Psychiatrist

ABSTRACT

Background: Mental assessment for patients in a palliative care unit with no regular psychiatrist tends to depend on subjective judgments by other health professionals. We introduced the 9-item Patient Health Questionnaire (PHQ-9) to screen major depression from patients in a palliative care unit and assessed the usefulness of the questionnaire. Methods: The subjects were all patients who were admitted to a palliative care unit. Each patient was asked to answer the PHQ-9 on admission and then was interviewed by a psychiatrist. When PHQ-9 score was of 10 points and above, the case was judged to be positive for depressive disorder. A psychiatrist diagnosed according to Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Results: A total of 83 patients were hospitalized between January 2016 and October 2016. 50 patients completed PHQ-9 and psychiatrist’s interview. Nine cases were positive by PHQ-9 and diagnosed as depressive disorder by a psychiatrist. Seven cases were positive by the PHQ-9 but not diagnosed as depressive disorder. Although 34 cases were judged to be negative by the PHQ-9, 2 cases of them were diagnosed as depressive disorder. The sensitivity and specificity of the PHQ-9 were 81.8% and 82.1% respectively. Conclusion: We found that the PHQ-9 was useful screening test for depression even in palliative care settings.