TY - JOUR 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 SP - e231 LP - e238 DO - 10.3399/bjgp10X502119 VL - 60 IS - 575 AU - Alice Malpass AU - Alison Shaw AU - David Kessler AU - Deborah Sharp Y1 - 2010/06/01 UR - http://bjgp.org/content/60/575/e231.abstract N2 - 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. ER -