Primary-care providers using brief depression symptom measures, such as 2-item or 9-item versions of the Patient Health Questionnaire (PHQ), were 3 times more likely to prescribe antidepressant medications to patients for whom such treatment is not recommended, according to a report in Journal of the American Board of Family Medicine (2014;27[5]:611-620).
Anthony Jerant, MD, and colleagues studied 595 participants with a score under 10 on a 9-item PHQ, or PHQ-9. The questionnaires were administered by the investigators on the same day the patients had appointments to see their primary-care providers.
The clinicians did not know the patients had completed the PHQ-9. Researchers reviewed patient charts to determine who had been independently asked by their provider to complete a brief depression symptom measure (545) and who had not (50).
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When no questionnaire was independently administered by the primary-care provider, 10.5% of patients received a diagnosis of depression and 3.8% were prescribed antidepressants. Of those patients who completed brief depression questionnaires during their primary-care visits, 20% were diagnosed with depression and 12% were prescribed antidepressants.
The authors noted that PHQ-9 validation studies have found that only approximately 1% of persons with a questionnaire score under 10 have major depression, which is the only form of depression that has consistently been shown in randomized controlled trials to benefit from antidepressants.
