Detecting recurrent major depressive disorder within primary care rapidly and reliably using short questionnaire measures

Thapar, Ajay Kumar ORCID: https://orcid.org/0000-0002-4589-8833, Hammerton, Gemma, Collishaw, Stephan ORCID: https://orcid.org/0000-0002-4296-820X, Potter, Robert, Rice, Frances ORCID: https://orcid.org/0000-0002-9484-1729, Harold, Gordon Thomas, Craddock, Nicholas John ORCID: https://orcid.org/0000-0003-2171-0610, Thapar, Anita ORCID: https://orcid.org/0000-0002-3689-737X and Smith, Daniel 2014. Detecting recurrent major depressive disorder within primary care rapidly and reliably using short questionnaire measures. British Journal of General Practice (BJGP) 64 (618) , e31-7. 10.3399/bjgp14X676438

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Abstract

BACKGROUND: Major depressive disorder (MDD) is often a chronic disorder with relapses usually detected and managed in primary care using a validated depression symptom questionnaire. However, for individuals with recurrent depression the choice of which questionnaire to use and whether a shorter measure could suffice is not established. AIM: To compare the nine-item Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory, and the Hospital Anxiety and Depression Scale against shorter PHQ-derived measures for detecting episodes of DSM-IV major depression in primary care patients with recurrent MDD. DESIGN AND SETTING: Diagnostic accuracy study of adults with recurrent depression in primary care predominantly from Wales METHOD: Scores on each of the depression questionnaire measures were compared with the results of a semi-structured clinical diagnostic interview using Receiver Operating Characteristic curve analysis for 337 adults with recurrent MDD. RESULTS: Concurrent questionnaire and interview data were available for 272 participants. The one-month prevalence rate of depression was 22.2%. The area under the curve (AUC) and positive predictive value (PPV) at the derived optimal cut-off value for the three longer questionnaires were comparable (AUC = 0.86-0.90, PPV = 49.4-58.4%) but the AUC for the PHQ-9 was significantly greater than for the PHQ-2. However, by supplementing the PHQ-2 score with items on problems concentrating and feeling slowed down or restless, the AUC (0.91) and the PPV (55.3%) were comparable with those for the PHQ-9. CONCLUSION: A novel four-item PHQ-based questionnaire measure of depression performs equivalently to three longer depression questionnaires in identifying depression relapse in patients with recurrent MDD.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Research Institutes & Centres > MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG) Schools > Medicine Research Institutes & Centres > Neuroscience and Mental Health Research Institute (NMHII)
Subjects:	R Medicine > R Medicine (General)
Publisher:	Royal College of General Practitioners
ISSN:	0960-1643
Last Modified:	05 Nov 2025 22:52
URI:	https://orca.cardiff.ac.uk/id/eprint/75537

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