TY - JOUR
AU - V. T. Lino
AU - M. C. Portela
AU - L. A. Camacho
AU - S. Atie
AU - M. J. Lima
AU - N. C. Rodrigues
AU - M. B. Barros
AU - M. K. Andrade
A1 - 
AB - INTRODUCTION: Depression is one of the most common mental disorders and a leading cause of disability worldwide. It constitutes a serious public health problem, particularly among elderly individuals. Most depressed elderly patients are treated by primary care (PC) physicians. The "Patient Health Questionnaire" (PHQ-2) is an instrument used for the detection of depression in PC settings. OBJECTIVE: Evaluate the performance of the PHQ-2 in a low-income and uneducated elderly PC population. METHODS: A non-probabilistic population sample of 142 individuals was selected from the healthcare unit's users >== 60 years. Criterion validity was assessed by estimating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PHQ-2 in comparison with the structured interview using the DSM-IV. The estimates of sensitivity and specificity were obtained from varying cut-offs of the PHQ-2 score. A Receiver Operator Characteristic (ROC) curve was constructed and the area under the curve (AUC) was calculated. RESULTS: The group was predominantly female (73.9%), with low education level (mean 3 years of schooling). The mean age was 72.5 years old. The prevalence of depression was 26.1%. The best values of sensitivity (0.74), specificity (0.77), PPV (0.50) e NPV (0.90) were obtained with score equal to 1. The AUC was 0.77, indicating a modest performance of the test accuracy. CONCLUSION: The simplicity of the PHQ-2 is an advantage for its use in PC. The high NPV indicated that 90% of those who tested negative would not need additional tests. However, the low PPV indicated that the PHQ-2 is not sufficient to screen for depression. The application of the instrument could be the first step of the screening, that would include a second step to all those with positive tests formerly.
BT - PloS one
C5 - Healthcare Disparities; Measures
CP - 12
CY - United States
DO - 10.1371/journal.pone.0113778
IS - 12
JF - PloS one
N2 - INTRODUCTION: Depression is one of the most common mental disorders and a leading cause of disability worldwide. It constitutes a serious public health problem, particularly among elderly individuals. Most depressed elderly patients are treated by primary care (PC) physicians. The "Patient Health Questionnaire" (PHQ-2) is an instrument used for the detection of depression in PC settings. OBJECTIVE: Evaluate the performance of the PHQ-2 in a low-income and uneducated elderly PC population. METHODS: A non-probabilistic population sample of 142 individuals was selected from the healthcare unit's users >== 60 years. Criterion validity was assessed by estimating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PHQ-2 in comparison with the structured interview using the DSM-IV. The estimates of sensitivity and specificity were obtained from varying cut-offs of the PHQ-2 score. A Receiver Operator Characteristic (ROC) curve was constructed and the area under the curve (AUC) was calculated. RESULTS: The group was predominantly female (73.9%), with low education level (mean 3 years of schooling). The mean age was 72.5 years old. The prevalence of depression was 26.1%. The best values of sensitivity (0.74), specificity (0.77), PPV (0.50) e NPV (0.90) were obtained with score equal to 1. The AUC was 0.77, indicating a modest performance of the test accuracy. CONCLUSION: The simplicity of the PHQ-2 is an advantage for its use in PC. The high NPV indicated that 90% of those who tested negative would not need additional tests. However, the low PPV indicated that the PHQ-2 is not sufficient to screen for depression. The application of the instrument could be the first step of the screening, that would include a second step to all those with positive tests formerly.
PP - United States
PY - 2014
SN - 1932-6203; 1932-6203
T1 - Screening for depression in low-income elderly patients at the primary care level: use of the Patient Health Questionnaire-2
T2 - PloS one
TI - Screening for depression in low-income elderly patients at the primary care level: use of the Patient Health Questionnaire-2
U1 - Healthcare Disparities; Measures
U2 - 25473845
U3 - 10.1371/journal.pone.0113778
VL - 9
VO - 1932-6203; 1932-6203
Y1 - 2014
ER -