As part of the National Depression Management Leadership Initiative,
psychiatrists and primary care physicians participating in the project are
beginning to use the Patient Health Questionnaire-9 (PHQ-9) as part of routine
R. Scott Benson, M.D., a psychiatrist in a group practice in Pensacola,
Fla., was an early starter—he began using the PHQ-9 to monitor his
patients for depressive symptoms a year before he joined the depression
initiative. "I was always looking for a way to measure depression in my
patients," he told Psychiatric News.
The PHQ-9 enables him to track patients' depressive symptoms over time,
Benson noted, and gives him an objective way to measure whether they are
improving or getting worse.
"Instead of having to go through the whole inventory of depression
symptoms," he said, "I can just look at those symptoms that have
changed over time and say to the patient, for example, `I see that you are
having more trouble sleeping,'" remarked Benson.
He said he views administering the PHQ-9 to patients as "consistent
with [his] professional goals" because it helps him collaborate with
patients on their recovery. "I need to work with my patients to help
them attain their goals." He also noted that there is"
enormous" variation in treatment approaches for psychiatric
disorders. "As psychiatrists, we need better science to guide what we
do," he said.
Linda Stuart, M.D., a family practice physician in Baton Rouge, La., is
also giving the PHQ-9 to patients as part of the National Depression
Management Leadership Initiative.
She said that before she joined the study, she queried certain patients
about possible depressive symptoms, but not as part of a standardized routine."
Having the PHQ-9 handy formalizes" depression evaluation, she
Currently, she gives the entire questionnaire to patients she thinks may be
depressed. However, she will soon embed the first two questions of the PHQ-9
into a general health questionnaire that new patients and those who come for
their annual visit must complete.
The questions ask patients whether over the previous two weeks they have
experienced loss of interest or pleasure in their activities and whether they
have felt "down, depressed, or hopeless" along a continuum ranging
from "not at all" to "nearly every day." Patients who
answer yes to either one of these questions will be asked to complete the
entire questionnaire, she said. ▪