Why the study?
Screening for poststroke depression using a valid and reliable tool is recommended, but the specificity, sensitivity, and appropriateness of the PHQ-9 needed identification.
Is the PHQ-9 a sensitive and specific tool for screening poststroke depression in stroke survivors?
Systematic Review (n=930)
Is the PHQ-9 a sensitive and specific tool for screening poststroke depression in stroke survivors?
Current evidence is inconclusive regarding the reliability of the PHQ-9 for screening poststroke depression, highlighting the need for clinical validation using standard diagnostic interviews before initiating treatment.
PHQ-9 should not yet guide poststroke depression screening; leaves open its validity pending complete diagnostic accuracy studies.
BACKGROUND: Screening for poststroke depression (PSD) using a valid and reliable tool is recommended for all stroke survivors. This literature review identifies the specificity, sensitivity, and appropriateness of the 9-item Patient Health Questionnaire (PHQ-9) to screen stroke patients for PSD. METHODS: Relevant databases were searched using the following selection criteria: (1) peer-reviewed primary research, (2) published from 2012 to 2018 (to evaluate the most recent research using this tool), and (3) examined the specificity and sensitivity of the PHQ-9 for screening stroke survivors for PSD. RESULTS: Six studies, with an overall level of evidence grade of "B," representing an overall total sample size of 930 participants (851 given a diagnosis of stroke and 49 given a diagnosis of transient ischemic attacks) met criteria for inclusion in the review. Only 2 studies reported data on all of the components necessary to determine the robustness of this tool to screen for depression in stroke survivors. CONCLUSION: Evidence regarding the sensitivity and specificity of the PHQ-9 to screen stroke patients for PSD is inconclusive. Additional research is needed to address the appropriateness of the PHQ-9 as a depression screening tool in this population. Clinicians should validate the results of PHQ-9 screening of ischemic stroke patients for PSD with the Structured Clinical Interview for DSM-5, the standard for diagnosing depression, before initiating treatment of PSD.
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Trotter et al. (2019) conducted a systematic review in Poststroke depression (n=930). 9-item Patient Health Questionnaire (PHQ-9) was evaluated on Sensitivity and specificity of the PHQ-9 for screening stroke survivors for poststroke depression.
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