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

doi:10.1016/j.jpsychires.2015.06.018

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

Houston Methodist

Research output: Contribution to journal › Article › peer-review

15 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	114-119
Number of pages	6
Journal	Journal of Psychiatric Research
Volume	68
DOIs	https://doi.org/10.1016/j.jpsychires.2015.06.018
State	Published - Sep 1 2015

Keywords

Diagnostic efficiency
PHQ-9
Prediction
Treatment non-response

ASJC Scopus subject areas

Psychiatry and Mental health
Biological Psychiatry

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10.1016/j.jpsychires.2015.06.018

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

abstract = "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.",

keywords = "Diagnostic efficiency, PHQ-9, Prediction, Treatment non-response",

author = "Fowler, {James Chris} and Michelle Patriquin and Alok Madan and Allen, {Jon G.} and Frueh, {B. Christopher} and Oldham, {John M.}",

note = "Funding Information: This research was partially supported by the Menninger Clinic Foundation, McNair Medical Institute, Vivian L. Smith Foundation, and the Huffington Foundation. Drs. Frueh and Madan are McNair Scholars. The study follows the guidelines on good publication practices. The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or manuscript. Thus, the authors were independent from study sponsors in the context of the research. Publisher Copyright: {\textcopyright} 2015 Elsevier Ltd.",

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doi = "10.1016/j.jpsychires.2015.06.018",

language = "English (US)",

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AU - Fowler, James Chris

AU - Patriquin, Michelle

AU - Madan, Alok

AU - Allen, Jon G.

AU - Frueh, B. Christopher

AU - Oldham, John M.

N1 - Funding Information: This research was partially supported by the Menninger Clinic Foundation, McNair Medical Institute, Vivian L. Smith Foundation, and the Huffington Foundation. Drs. Frueh and Madan are McNair Scholars. The study follows the guidelines on good publication practices. The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or manuscript. Thus, the authors were independent from study sponsors in the context of the research. Publisher Copyright: © 2015 Elsevier Ltd.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - 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.

AB - 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.

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

Abstract

Keywords

ASJC Scopus subject areas

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