Early identification of treatment non-response utilizing the Patient Health Questionnaire (PHQ-9)

James Chris Fowler, Michelle Patriquin, Alok Madan, Jon G. Allen, B. Christopher Frueh, John M. Oldham

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: Treatment non-response among high-risk, psychiatric patients exposes those suffering to suicidal risk as well as persistent social and occupational difficulties. Strategies for identification of treatment non-response are limited. Aims: Diagnostic efficiency of a self-report, cross-cutting symptom measure was assessed as a marker of treatment non-response. Method: 835 inpatients at a specialist psychiatric hospital completed the Patient Health Questionnaire - Depression (PHQ-9) at admission and every two weeks during hospitalization. Results: For patients admitted with severe depression (PHQ-9≥20), results indicated good accuracy of 2-week PHQ-9 change score in identifying treatment non-response (AUC=0.80, SE=0.04, p<.0001; sensitivity=85%; specificity=73%; OR=14.91). Conclusions: The search for predictors of non-response to psychiatric treatment has a long and generally unfulfilled history. The PHQ-9 change score holds promise as a cost-effective test with comparable diagnostic characteristics to other medical tests.

Original languageEnglish (US)
Pages (from-to)114-119
Number of pages6
JournalJournal of Psychiatric Research
StatePublished - Sep 1 2015


  • Diagnostic efficiency
  • PHQ-9
  • Prediction
  • Treatment non-response

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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