Screening for Depressive Disorder in Elderly Patients with Chronic Physical Diseases Using the Patient Health Questionnaire-9.
- Author:
Seon Cheol PARK
1
;
Hwa Young LEE
;
Dong Woo LEE
;
Sang Woo HAHN
;
Sang Ho PARK
;
Yeo Ju KIM
;
Jae Sung CHOI
;
Ho Sung LEE
;
Soyoung Irene LEE
;
Kyoung Sae NA
;
Sung Won JUNG
;
Se Hoon SHIM
;
Ki Won KIM
;
Jong Woo PAIK
;
Young Joon KWON
Author Information
- Publication Type:Original Article
- Keywords: Depressive disorder; Elderly; Chronic physical diseases; Patient health questionnaire-9
- MeSH: Aged*; Coronary Artery Disease; Depression; Depressive Disorder*; Hospitals, General; Humans; Korea; Logistic Models; Mass Screening*; Odds Ratio; ROC Curve; Sensitivity and Specificity
- From:Psychiatry Investigation 2017;14(3):306-313
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: We aimed to identify depressive symptom profiles that indicated the presence of depressive disorder and present optimal cut-off sub-scores for depressive symptom profiles for detecting depressive disorder in elderly subjects with chronic physical diseases including diabetes, chronic obstructive pulmonary disease/asthma, and coronary artery disease, using the Patient Health Questionnaire-9 (PHQ-9). METHODS: Two hundred and thirty-one elderly patients with chronic physical diseases were recruited consecutively from a university-affiliated general hospital in South Korea. RESULTS: Greater severities of all 9 depressive symptoms in the PHQ-9 were presented in those with depressive disorder rather than those without depressive disorder. A binary logistic regression modeling presented that little interest [adjusted odds ratio (aOR)=4.648, p<0.001], reduced/increased sleep (aOR=3.269, p<0.001), psychomotor retardation/agitation (aOR=2.243, p=0.004), and concentration problem (aOR=16.116, p<0.001) were independently associated with increased likelihood of having depressive disorder. Receiver operating characteristics (ROC) curve analysis presented that the optimal cut-off value of score on the items for little interest, reduced/increased sleep, psychomotor retardation/agitation and concentration problem (PHQ-9) for detecting depressive disorder was 4 with 61.9% of sensitivity and 91.5% of specificity [area under curve (AUC)=0.937, p<0.001]. CONCLUSION: Our findings suggested that the diagnostic weighting of little interest, reduced/increased sleep, psychomotor retardation/agitation, and concentration problem is needed to detect depressive disorder among the elderly patients with chronic physical diseases.
