An Efficient Way to Detect Poststroke Depression by Subsequent Administration of a 9-Item and a 2-Item Patient Health Questionnaire

Background and Purpose-The early detection of poststroke depression is essential for optimizing recovery after stroke. A prospective study was conducted to investigate the diagnostic value of the 9-item and the 2-item Patient Health Questionnaire (PHQ-9, PHQ-2). Methods-One hundred seventy-one consecutive patients with stroke who could communicate adequately were included. In the 6th to 8th weeks after stroke, depression was measured using the PHQ-9 and PHQ-2 and diagnosed using the Composite International Diagnostic Interview. Results-Of the participating patients, 20 (12.2%) were depressed. The PHQ- 9 performed best at a score >= 10, a sensitivity of 0.80 (95% CI, 0.62-0.98), and a specificity of 0.78 (95% CI, 0.72-0.85) and the PHQ-2 at a score >= 2 with a sensitivity of 0.75 (95% CI, 0.56-0.94) and a specificity of 0.76 (95% CI, 0.69-0.83). Administering the PHQ- 9 only to patients who scored >= 2 on the PHQ-2 improved the identification of depression (sensitivity, 0.87; 95% CI, 0.69-1.04). Conclusions-The diagnostic value is acceptable to good for PHQ-9 scores >= 10 and PHQ-2 scores >= 2. Conducting a PHQ-9 only in patients with a PHQ-2 score >2 generates the best results. (Stroke. 2012;43:854-856.)