Article

OBJECTIVE: To investigate the validity of the Patient Health Questionnaire-9
(PHQ-9) depression screening measure in people undergoing acute inpatient
rehabilitation for spinal cord injury (SCI). DESIGN: We performed a blinded
comparison of the PHQ-9 administered by research staff with the major depression
module of the Structured Clinical Interview for the Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition (SCID) conducted by a mental health
professional. SETTING: Inpatient rehabilitation units. PARTICIPANTS: Participants
(N=142) were patients undergoing acute rehabilitation for traumatic SCI who were
at least 18 years of age, English speakers, and without severe cognitive, motor
speech, or psychotic disorders. We obtained the SCID on 173 (84%) of 204 eligible
patients. The final sample of 142 patients (69%) consisted of those who underwent
both assessments within 7 days of each other. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: PHQ-9 and SCID major depression module. RESULTS: Participants
were on average 42.2 years of age, 78.2% men, and 81.7% white, and 66.9% had
cervical injuries. The optimal PHQ-9 cutoff (>/=11) resulted in 35 positive
screens (24.6%). Key indices of criterion validity were as follows: sensitivity,
1.00 (95% confidence interval [CI], .73-1.00); specificity, .84 (95% CI,
.76-.89); Youden Index, .84; positive predictive value, .40 (95% CI, .24-.58);
and negative predictive value, 1.00 (95% CI, .96-1.00). The area under the
receiver operator curve was .92, and kappa was .50. Total PHQ-9 scores were
inversely correlated with subjective health state and quality of life since SCI.
CONCLUSIONS: The PHQ-9 meets criteria for good diagnostic accuracy compared with
a structured diagnostic assessment for major depressive disorder even in the
context of inpatient rehabilitation for acute traumatic SCI.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS