Patient Health Questionaire-9 Research Articles

Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship

Co-occurring depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival if left untreated. The purpose of this study was to explore risk factors for depression among Latina breast cancer survivors. A closed-ended questionnaire was administered by telephone to 68 Latinas diagnosed with breast cancer within the past 5 years. Depression symptoms were measured using the Patient Health Questionaire-9 with the Endicott substitutive criteria applied. The Cognitive Appraisal Health Scale and the Brief COPE were used to measure appraisal and coping. Descriptive statistics, bivariate and multiple linear regression analyses were completed. Approximately 45.6% of women reported depressive symptoms. Multivariate analyses showed that a cognitive appraisal variable (decreased challenge or the potential to overcome), coping variables (increased acceptance, less positive reframing, less active coping, less use of emotional support, substance use and more self-blame), poor body image, less family and peer support to be significantly associated with an increased risk for depression. Intrapersonal variables accounted for the greatest explained variance (69%). This study identified several risk factors for depression. Study findings highlight the need for intervention programs to help women normalize emotions and thoughts related to cancer and its treatments, and to improve their cognitive abilities to overcome, accept, and positively reframe cancer and other difficult situations women face throughout the cancer continuum. The importance of family and peer support to improve depressive symptoms was also evident.

Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda

Depressive disorders are highly prevalent in Africa where diseases such as HIV/AIDS are common. The aim of this study was to assess the validity of commonly used depression screening instruments in a setting characterized by low literacy, where patients may not be able to self-administer depression scales. We explored the validity of the Patient Health Questionaire-9 (PHQ-9), Centre for Epidemiological Surveys for Depression (CES-D), and the Kessler-10 (K-10), using the Mini International Neuropsychiatric Instrument (MINI) as a gold standard in 368 persons living with HIV/AIDS (PLWHA) in Uganda. The shorter versions of the K-10 and PHQ-9 were extracted to assess their performance in comparison to the longer versions. We used STATA 11.2 to analyze the data. The prevalence of a MINI defined depression in this patient sample was 17.4%. The three instruments all performed well, with areas under the curve (AUC) ranging from 0.82 to 0.96. The PHQ-9 showed the best performance characteristics with an AUC of 0.96, a sensitivity of 91.6%, and specificity 81.2%. The extracted versions performed more modestly. All three instruments showed good properties as screening tools; the PHQ-9 has particularly high sensitivity and specificity, and so can be considered useful for screening HIV-positive patients for depression.

Pains, Joys, and Secrets: Nurse-Led Group Therapy for Older Adults with Depression

This is the first study of nurse-led group therapy in Mexico. Forty-one depressed older adults with a median age of 71 participated in nurse-led cognitive behavioral group therapy once a week for 12 weeks. Participants’ scores on the Patient Health Questionaire-9 showed mild to moderate improvement. Participants experienced positive results in personal growth, changing negative thoughts, and relationships with family. An important therapeutic factor was the support of fellow group members. The nurses experienced positive personal and professional growth. Difficulties included physician resistance and a too-rigid cognitive behavioral group therapy model. A combination of cognitive behavioral therapy and supportive group therapy is recommended.