Abstract T P310: PHQ-2 Screens for Early Depression in Acute Stroke

Abstract

Background: New quality care requirements include screening for depression in patients with acute stroke. The Patient Health Questionnaire-2 and -9 (PHQ-2, PHQ-9) are validated tools utilized for depression screening. Early screening during the hospital stay may have a higher yield for earlier initiation of treatment and potentially better recovery outcomes. In addition, patients with higher stroke severity may exhibit a higher PHQ-2 and -9 scores. Purpose: Average length of stay of all patients with acute stroke at our institution is 3.87 days; this requires depression screening within 2-4 days of admission. The purpose of this study is to identify the utility of post-stroke depression screening tool in acute care in correlation with the day the tool was utilized. Further correlation with the stroke severity will be determined. . Methods: All staff on every stroke unit were educated on the depression screening tool which was used in compliance with our protocols. We performed a retrospective chart review, in which we collected information on the type of stroke, treatment, history of depression, NIHSS score on admission and discharge, PHQ-2 and PHQ-9, and hospital day of screening. Pearson correlation coefficient was measured for the scores on screening tools with days it was performed. Results: Among all patients, screening for depression was performed on 206 patients,. The mean age of the cohort 68.6 ± 14.1; 53% females with initial mean NIHSS 7.6 ± 8.3 and discharge NIHSS 3.8 ± 7.9. The average hospital day when the tool was utilized was 3.73 ± 2.7. There was a positive correlation found with the PHQ-2 and the days when the tool was utilized (Pearson coefficient 0.16, P = 0.01). This correlation was not found between PHQ-9 (Pearson coefficient 0.053, P > 0.05). PHQ-2 also correlated with the initial and discharge NIHSS scale (Pearson coefficient 0.31 and 0.30, P <0.05); this correlation was not found with PHQ-9. Conclusion: PHQ-2 is a helpful tool in detecting depression when used early in the course of acute stroke. In addition, there is a positive correlation between PHQ-2 and stroke severity.