Key result
PHQ-9 item 9 detects suicidal ideation with ~0.84 AUC versus C-SSRS in breast cancer patients.
Why the study?
It was unclear whether Patient Health Questionnaire-9 (PHQ-9) item 9 alone is sufficient compared to the C-SSRS for detecting suicidal ideation among patients with breast cancer.
Does PHQ-9 item 9 accurately detect suicidal ideation compared to C-SSRS in female breast cancer patients?
Cross-Sectional (n=176)
No
Does PHQ-9 item 9 accurately detect suicidal ideation compared to C-SSRS in female breast cancer patients?
Odds Ratio: 36 (95% CI 14.68–88.29)
p-value: p=<0.001
PHQ-9 item 9 demonstrates good discriminatory power for identifying wish for death and active suicidal ideation in female breast cancer patients, serving as a valuable screening tool.
Supports PHQ-9 item 9 for screening in breast cancer; leaves open prospective validation versus C-SSRS.
Background: The Columbia-Suicide Severity Rating Scale (C-SSRS) is the gold standard for assessing suicidal ideation, behavior, and risk.However, it is unclear whether the Patient Health Questionnaire-9 (PHQ-9) item 9 alone is sufficient for detecting suicidal ideation among patients with breast cancer.This study aimed to assess the validity of PHQ-9 item 9 compared to C-SSRS in female breast cancer patients undergoing psychiatric treatment.Methods: In this study, we evaluated the validity of PHQ-9 item 9 compared to C-SSRS for identifying suicidal ideation among 176 female patients with breast cancer receiving psychiatric treatment, using self-reported questionnaires and leveraging demographic, clinical data, and statistical analyses to refine suicide risk assessment methods.Results: Among 176 patients, 35.2% showed a positive response to PHQ-9 item 9, 41.0% and 17.0% of them showed a response indicating wish for death and active suicidal ideation based on C-SSRS, respectively.The areas under the ROC curves for wish for death and active suicidal ideation were 0.840 and 0.842, respectively, indicating good discriminatory power with an optimal cut-off of 1/3 for both criteria.Conclusion: Although PHQ-9 item 9 may have limited utility in detecting active suicidal ideation among patients with breast cancer, it may serve as a valuable screening tool for identifying those at risk of having thoughts of suicide accompanied by wish for death.
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C. Hyung Keun Park (2025) conducted a cross-sectional in Breast cancer (n=176). PHQ-9 item 9 vs. Columbia-Suicide Severity Rating Scale (C-SSRS) was evaluated on C-SSRS-defined wish for death (OR 36.00, 95% CI 14.68-88.29, p=<0.001). PHQ-9 item 9 demonstrated good discriminatory power for detecting a wish for death (AUC 0.840) and active suicidal ideation (AUC 0.842) compared to the C-SSRS in female breast cancer patients.
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