Korean J Fam Pract 2019; 9(4): 336-340  https://doi.org/10.21215/kjfp.2019.9.4.336
Usefulness of the Patient Health Questionnaire-2 in Screening for Depression
Minkyeung Jo1, Hye Yeon Koo2, In Young Cho2, Yoojin Lee1, Sojung Yoon1, Yeseul Yang1, Ju Young Kim2, Kiheon Lee2, Kee Hyuck Lee2, Se Young Jung2, Hyejin Lee2, Jong Soo Han3, Sarah Kim4, Woo Kyung Bae3,*
1Department of Family Medicine, Seoul National University Hospital, Seoul; 2Department of Family Medicine, Seoul National University Bundang Hospital; 3Department of Family Medicine, Health Promotion Center, Seoul National University Bundang Hospital; 4International Healthcare Center, Seoul National University Bundang Hospital, Seongnam, Korea
Woo Kyung Bae
Tel: +82-31-787-7805, Fax: +82-31-787-4078
E-mail: 65597@snubh.org
ORCID: http://orcid.org/0000-0001-6729-4128
Received: July 25, 2018; Revised: February 23, 2019; Accepted: June 3, 2019; Published online: August 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: While various screening tools are available for depression, they are not feasible in clinical practice because of their excessive number of questions. The Patient Health Questionnaire-2 (PHQ-2) consists of two questions gauging the frequency of depressed mood and anhedonia over the past two weeks. This study aimed to assess the usefulness of the PHQ-2 as a brief screening tool for depression.
Methods: This study used Korean National Health and Nutrition Examination Survey data from 2014, and the study population consisted of 4,946 individuals. We analyzed the validity of the PHQ-2 compared with ‘depression by PHQ-9,’ and obtained the optimal cut point for screening depression. The agreement between PHQ-2 and depression by PHQ-9 and the agreement between PHQ-2 and ‘currently diagnosed as depression’ were analyzed using Cohen’s kappa. The correlation between EuroQol-5D (EQ-5D) index scores and PHQ-2 scores was analyzed using Student’s t-test.
Results: Using ‘depression by PHQ-9’ as the criterion standard, PHQ-2 scores ≥2 had a sensitivity of 89% and a specificity of 87%, and a receiver operating characteristic analysis identified PHQ-2 ≥2 as the optimal cut point for screening. The agreement between PHQ-2 and depression by PHQ-9 was 0.430 when PHQ-2 ≥2 was used as a cut point. The agreement between PHQ-2 and ‘depression by questionnaire’ was poor. The EQ-5D index score of the depressive group was significantly lower than that of the normal group.
Conclusion: The PHQ-2 is an effective measure for screening depression and is expected to be useful in busy clinical settings.
Keywords: Depression; Mass Screening; Patient Health Questionnaire; Surveys and Questionnaires
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