Making the cut: Depression screening in urban general hospital clinics for culturally diverse Latino populations - 18/04/17
, Carole Siegel b, ⁎ , Eugene Laska b , Joseph Wanderling c , Ellen Cogen Wagner d , Gary Haugland c , Mary K. Conlon e Abstract |
Objectives |
We examined whether the cut-point 10 for the Patient Health Questionnaire-9 (PHQ9) depression screen used in primary care populations is equally valid for Mexicans (M), Ecuadorians (E), Puerto Ricans (PR) and non-Hispanic whites (W) from inner-city hospital-based primary care clinics; and whether stressful life events elevate scores and the probability of major depressive disorder (MDD).
Methods |
Over 18-months, a sample of persons from hospital clinics with a positive initial PHQ2 and a subsequent PHQ9 were administered a stressful life event questionnaire and a Structured Clinical Interview to establish an MDD diagnosis, with oversampling of those between 8 and 12: (n=261: 75 E, 71 M, 51 PR, 64 W). For analysis, the sample was weighted using chart review (n=368) to represent a typical clinic population. Receiver Operating Characteristics analysis selected cut-points maximizing sensitivity (Sn) plus specificity (Sp).
Results |
The optimal cut-point for all groups was 13 with the corresponding Sn and Sp estimates for E=(Sn 73%, Sp 71%), M=(76%, 81%), PR=(81%, 63%) and W=(80%, 74%). Stressful life events impacted screen scores and MDD diagnosis.
Conclusions |
Elevating the PHQ9 cut-point for inner-city Latinos as well as whites is suggested to avoid high false positive rates leading to improper treatment with clinical and economic consequences.
Le texte complet de cet article est disponible en PDF.Keywords : Latinos, Immigrant health, Depression screening
Plan
| ☆ | All authors contributed to the conduct of this study and writing of the paper and have approved the manuscript. Authors report no conflicts of interest. |
Vol 45
P. 85-90 - mars 2017 Retour au numéro
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