Thursday, September 19, 2013

Depression Questionnaire Item Helps Identify Patients at Risk of Suicide, Study Finds

One question on the nine-item Patient Health Questionnaire (PHQ-9), a depression-assessment tool commonly used in clinical practice, can help identify outpatients who have an increased risk of suicide attempt or suicide death, according to a report in the APA journal Psychiatric Services in Advance

Researchers at the 650,000-member Group Health Cooperative in Washington state and Idaho, led by Gregory Simon, M.D., M.P.H., used electronic medical records of patients who were seen for a depression-related visit for a five-year period beginning in 2007. They evaluated the ability of item 9 to assess suicidal ideation. It asks: "Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way?" Response options are "not at all," "several days," "more than half the days," or "nearly every day."

At one year, the probability of a suicide attempt or completed suicide ranged from about .4% for those answering "not at all" to 4% (1 in 25) for those answering "nearly every day." Even after accounting for treatment history and demographic factors, "item 9 remained a strong predictor of any suicide attempt," the researchers said. Immediate risk was low, they noted, but increased over several days and persisted over several months. Treating clinicians were aware of PHQ-9 results, so the risks found "reflect the consequences of any clinical response" to questionnaire answers. They concluded that while denying suicidal thoughts "does not rule out subsequent suicide attempt,...Systematic use of the PHQ-9 (or some other standard outcome assessment) is an essential element of effective depression treatment."

To read more about this study, see the report "Does Response on the PHQ-9 Depression Questionnaire Predict Subsequent Suicide Attempt or Suicide Death?" in Psychiatric Services in Advance.

(image: Robert Kneschke/


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