Patient Health Questionnaire Depression Scale as a Suicide Screening Instrument in Depressed Primary Care Patients

Article Abstract Objective: The aim of this study was to examine the sensitivity and specificity of the suicide item on the 9-item Patient Health Questionnaire (PHQ-9) when compared to a structured interview (the Structured Clinical Interview for DSM-IV; SCID-I mood module) in primary care patients with elevated depression symptoms. Method: In this cross-sectional study, we analyzed data from 166 patients from 2 primary care clinics, 1 in Rhode Island and 1 in Massachusetts, who were enrolled in studies that focused on depression in primary care. Of the total participants, 101 were enrolled in the survey study, and 65 were screened for or enrolled in either an open trial or a pilot randomized controlled trial. Data were collected between May 2004 and May 2009. Results: We found that the specificity of the PHQ-9 suicide screening item was 0.84 and sensitivity was 0.69 for the sample as a whole. Conclusions: This study suggests that the routine use of the PHQ-9 may be useful in primary care practice in that it may identify individuals at risk for suicide who would not otherwise have been identified. However, denial of suicidality on the PHQ-9 should be probed further if there are other risk factors for suicide present. Trial Registration: clinicaltrials.gov Identifier: NCT00541957 Prim Care Companion CNS Disord 2011;13(1):e1-e6 Submitted: May 27, 2010; accepted August 23, 2010. Published online: February 3, 2011 (doi:10.4088/PCC.10m01027). Corresponding author: Lisa A. Uebelacker, PhD, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906 (luebelacker@butler.org).