Key result
PHQ-9 screening demonstrates excellent diagnostic accuracy for detecting major depressive disorder in primary care.
Why the study?
Empirical evidence on the diagnostic accuracy of depression screening questionnaires in primary care patients at risk for depression remains limited.
Does the PHQ-9 accurately detect major depressive disorder in primary care patients with varying depression-related risk factors?
Cross-Sectional (n=985)
Does the PHQ-9 accurately detect major depressive disorder in primary care patients with varying depression-related risk factors?
Effect estimate: AUC 0.92-0.97
The PHQ-9 has high diagnostic accuracy for detecting major depressive disorder in primary care, supporting risk-adapted screening strategies.
Supports PHQ-9 screening in at-risk primary care; leaves open prospective validation of risk-adapted strategies.
BACKGROUND: International guidelines recommend risk-adapted depression screening in primary care. However, empirical evidence on the diagnostic accuracy of depression screening questionnaires in patients at risk for depression remains limited. OBJECTIVE: To evaluate the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for detecting major depressive disorder (MDD) in primary care, stratified by the presence of single depression-related risk factors and the amount of risk factors. METHODS: This secondary analysis used data from 985 primary care patients participating in the GET.FEEDBACK.GP trial who completed the PHQ-9, a depression-related risk factor assessment, and underwent evaluation for MDD using the Mini-International Neuropsychiatric Interview (MINI). Accounting for partial verification bias, this study applied an inverse probability weighting normalized for a sample of 985. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the curve (AUC) were calculated for different PHQ-9 cut-off scores across single risk factors and the amount of risk factors. The analysis was pre-registered (https://osf.io/wzctq). RESULTS: Of 985 participants, 89 (9.1%) had a MDD diagnosis. The best-performing PHQ-9 cut-offs, stratified by the amount of risk factors, varied, ranging from 7 to 13, with a higher number of risk factors being associated with a higher best-performing PHQ-9 cut-off score. Sensitivity ranged from 0.78 to 0.99; specificity from 0.80 to 0.91. PPV ranged from 0.40 to 0.88 and NPV from 0.80 to 0.99. AUCs ranged from 0.92 to 0.97, indicating excellent diagnostic accuracy. Similar results were found when stratifying by single risk factors. CONCLUSIONS: The PHQ-9 demonstrated high diagnostic accuracy for detecting MDD in patients at risk for depression. Although optimal cut-offs vary slightly according to the number and type of risk factors present, the findings support the validity of risk-adapted depression screening using the PHQ-9 in primary care.
No takes yet. Share an insight, caveat, or question.
Thake et al. (2026) conducted a cross-sectional in Major depressive disorder (MDD) (n=985). Patient Health Questionnaire-9 (PHQ-9) vs. Mini-International Neuropsychiatric Interview (MINI) was evaluated on Diagnostic accuracy for detecting major depressive disorder (MDD) (AUC 0.92-0.97). The PHQ-9 demonstrated excellent diagnostic accuracy for detecting major depressive disorder in primary care patients at risk for depression, with AUCs ranging from 0.92 to 0.97.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: