Psychiatry Investig.  2017 May;14(3):306-313. 10.4306/pi.2017.14.3.306.

Screening for Depressive Disorder in Elderly Patients with Chronic Physical Diseases Using the Patient Health Questionnaire-9

• Park SC
• Lee HY
• Lee DW
• Hahn SW
• Park SH
• Kim YJ
• Choi JS
• Lee HS
• Lee SI
• Na KS
• Jung SW
• Shim SH
• Kim KW
• Paik JW
• Kwon YJ

• KMID: 2378646
• DOI: http://doi.org/10.4306/pi.2017.14.3.306

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.

Keyword

Depressive disorder; Elderly; Chronic physical diseases; Patient health questionnaire-9

MeSH Terms

Aged*
Coronary Artery Disease
Depression
Depressive Disorder*
Hospitals, General
Humans
Korea
Logistic Models
Mass Screening*
Odds Ratio
ROC Curve
Sensitivity and Specificity