Validation of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with migraine

BACKGROUND: Psychiatric problems have been commonly reported in patients with migraine. This study investigated the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-9 (PHQ-2) in patients with migraine. METHODS: Patients with migraine (with or without aura) were consecutively recruited from our headache clinic. They completed several instruments, including the Mini International Neuropsychiatric Interview-Plus Version 5.0.0 (MINI), the PHQ-9, the Beck Depression Inventory-II (BDI-II), the Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test-6 (HIT-6), and the Migraine-Specific Quality of Life (MSQoL). RESULTS: Among 132 participants, 39 patients (29.5%) had a major depressive disorder (MDD) as determined by the MINI. Cronbach's α coefficients for the PHQ-9 and PHQ-2 were 0.894 and 0.747, respectively. At a cutoff score of 7, the PHQ-9 had a sensitivity of 79.5%, a specificity of 81.7%, a positive predictive value (PPV) of 64.6%, and a negative predictive value (NPV) of 90.5%. At a cutoff score of 2, the PHQ-2 had a sensitivity of 66.7%, a specificity of 90.3%, a PPV of 74.3%, and a NPV of 86.6%. The scores of the PHQ-9 and PHQ-2 well correlated with the BDI-II score, the MIDAS score, the HIT-6 score, and the MSQoL score. CONCLUSIONS: The PHQ-9 and PHQ-2 are both reliable and valid screening instruments for MDD in patients with migraine.