TY  - JOUR
PY  - 2010//
TI  - Concordance between PHQ-9 scores and patients' experiences of depression: a mixed methods study
JO  - British journal of general practice
A1  - Malpass, Alice
A1  - Shaw, Alison
A1  - Kessler, David
A1  - Sharp, Deborah
SP  - e231
EP  - 238
VL  - 60
IS  - 575
N2  - BACKGROUND: In 2009, a new indicator (DEP 3) was introduced into the Quality and Outcomes Framework. GPs are now encouraged to assess response to antidepressant treatment 5-12 weeks after the initial assessment, to guide clinical decision making. The Patient Health Questionnaire (PHQ-9) is one of the validated instruments that GPs can use to assess the patient's clinical state.  AIMS: To explore the extent to which changes in PHQ-9 score over time reflect patients' accounts of their experiences of depression during the same period; and to explore patients' experiences of using the PHQ-9 within primary care consultations.  DESIGN OF STUDY: Mixed methods.  SETTING: Primary care.  METHOD: Patients were recruited through six GP practices. The PHQ-9 and in-depth interviews were used at the same three time points over a 6-month period during a new or first episode of depression.  RESULTS: Patterns in the total PHQ-9 score broadly reflected patients' accounts of the severity of their depression over time. However, the PHQ-9 was inaccurate in its assessment of the presence and intensity of thoughts of self-harm, and missed symptoms that are meaningful to patients. At the diagnostic primary care consultation, patients viewed their score as a 'tangible' measure of their condition. Some patients requested the PHQ-9 subsequently as a way to measure their own treatment response and recovery process.  CONCLUSION: The potential therapeutic value of the PHQ-9 may be dependent upon the GP's willingness to openly discuss the results and what they may mean for the patient.<p /> <p>Language: en</p>
LA  - en
SN  - 0960-1643
UR  - http://dx.doi.org/10.3399/bjgp10X502119
ID  - ref1
ER  -