RT Journal Article
SR Electronic
T1 Concordance between PHQ-9 scores and patients’ experiences of depression: a mixed methods study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e231
OP e238
DO 10.3399/bjgp10X502119
VO 60
IS 575
A1 Alice Malpass
A1 Alison Shaw
A1 David Kessler
A1 Deborah Sharp
YR 2010
UL http://bjgp.org/content/60/575/e231.abstract
AB Background In 2009, a new indicator (DEP 3) was introduced into the Quality and Outcomes Framework. GPs are now encouraged to assess response to antidepressant treatment 5–12 weeks after the initial assessment, to guide clinical decision making. The Patient Health Questionnaire (PHQ-9) is one of the validated instruments that GPs can use to assess the patient's clinical state.Aims To explore the extent to which changes in PHQ-9 score over time reflect patients’ accounts of their experiences of depression during the same period; and to explore patients’ experiences of using the PHQ-9 within primary care consultations.Design of study Mixed methods.Setting Primary care.Method Patients were recruited through six GP practices. The PHQ-9 and in-depth interviews were used at the same three time points over a 6-month period during a new or first episode of depression.Results Patterns in the total PHQ-9 score broadly reflected patients’ accounts of the severity of their depression over time. However, the PHQ-9 was inaccurate in its assessment of the presence and intensity of thoughts of self-harm, and missed symptoms that are meaningful to patients. At the diagnostic primary care consultation, patients viewed their score as a ‘tangible’ measure of their condition. Some patients requested the PHQ-9 subsequently as a way to measure their own treatment response and recovery process.Conclusion The potential therapeutic value of the PHQ-9 may be dependent upon the GP's willingness to openly discuss the results and what they may mean for the patient.