Epidemiological evaluation of the Patient Health Questionnaire-2 in a pregnant population

Abstract

IntroductionThe Patient Health Questionnaire-2 (PHQ-2) is a commonly used 2-item screening tool for depressive symptoms among pregnant women in primary care settings. However, its validity has not been assessed for large-scale epidemiological studies. Therefore, the aim of this study was to provide an epidemiological evaluation of the PHQ-2 among pregnant women. MethodA total of 3033 pregnant women participating in the PRegnancy and Infant DEvelopment Study completed the PHQ-2 as well as the Hospital Anxiety Depression Scale-Depression (HADS-D) or the Edinburgh Depression Scale (EDS) three times throughout pregnancy. The validity of the PHQ-2 was assessed with the HADS-D/EDS as reference standard. ResultsSensitivity and specificity of the PHQ-2 were 69–84% and 79–84%, respectively. The positive predictive values (range 19–26%) were substantially lower than the negative predictive values (96–99%). ConclusionDespite the relatively high number of false-positive screens, initial screening for depression by two questions only may enhance routine evaluation of depressive symptoms among pregnant women.