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People with diabetes need a lower cut-off than others for depression screening with PHQ-9

Author

Listed:
  • Ewelina Cichoń
  • Andrzej Kiejna
  • Andrzej Kokoszka
  • Tomasz M Gondek
  • Rafał Radzio
  • Adam Jastrzębski
  • Beata E Andrzejewska
  • Fahad D Alosaimi
  • Cathy E Lloyd
  • Norman Sartorius

Abstract

Aims: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and ‘MDD and/or dysthymia’ in people with and without type 2 diabetes. Methods: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden’s index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. Results: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden’s index and ≥ 5 by the two-stage method for screening for MDD and ‘MDD and/or dysthymia’ in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and ‘MDD and/or dysthymia’ among people without diabetes (Youden’s index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for ‘MDD and/or dysthymia’ in people without diabetes. Conclusions: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.

Suggested Citation

  • Ewelina Cichoń & Andrzej Kiejna & Andrzej Kokoszka & Tomasz M Gondek & Rafał Radzio & Adam Jastrzębski & Beata E Andrzejewska & Fahad D Alosaimi & Cathy E Lloyd & Norman Sartorius, 2020. "People with diabetes need a lower cut-off than others for depression screening with PHQ-9," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-20, October.
    • Handle: RePEc:plo:pone00:0240209
    DOI: 10.1371/journal.pone.0240209
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    References listed on IDEAS

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    1. André Reimer & Andreas Schmitt & Dominic Ehrmann & Bernhard Kulzer & Norbert Hermanns, 2017. "Reduction of diabetes-related distress predicts improved depressive symptoms: A secondary analysis of the DIAMOS study," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-10, July.
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    Cited by:

    1. María Luisa Lozano del Hoyo & María Teresa Fernandez Rodrigo & Fernando Urcola-Pardo & Alicia Monreal-Bartolomé & Diana Cecilia Gracia Ruiz & Mercedes Gómez Borao & Ana Belén Artigas Alcázar & José Pe, 2022. "The TELE-DD Randomised Controlled Trial on Treatment Adherence in Patients with Type 2 Diabetes and Comorbid Depression: Clinical Outcomes after 18-Month Follow-Up," IJERPH, MDPI, vol. 20(1), pages 1-18, December.

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