The Patient Health Questionnaire depression screener in spinal cord injury

Julia M.P. Poritz, Joseph Mignogna, Aimee J. Christie, Sally A. Holmes, Herb Ames

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Context: Although depression is not inevitable following spinal cord injury/dysfunction (SCI/D), it can have a negative impact on rehabilitation. Evidence-based assessment of depression utilizing self-report instruments, such as the Patient Health Questionnaire-9 (PHQ-9), is considered good clinical practice. Although the PHQ-9 has been studied in individuals with SCI/D, little is known about the clinical utility of the Patient Health Questionnaire-2 (PHQ-2). Traditional cutoff scores for the PHQ-2 were examined to explore their operating characteristics as related to PHQ-9 results. Methods: Archival data were collected for 116 Veterans with SCI/D who completed the PHQ-2 and PHQ-9 as one component of their routine, comprehensive SCI annual evaluation at a Veterans Affairs Medical Center. Logistic regressions were performed to determine the impact of different cutoff scores for the PHQ-2 on the likelihood that participants would endorse clinically significant levels of depressive symptoms on the PHQ-9 (≥10). Results: Using a cutoff score of 3 or greater correctly classified 94.8% of the cases, outperforming the other cutoff scores. A cutoff score of 3 or greater had a sensitivity of 83.3% and specificity of 97.8%, and yielded a positive predictive value of 90.9% and a negative predictive value of 95.7%. Conclusion: The PHQ-2 shows promise as a clinically useful screener in the community-residing SCI/D population. Findings regarding the presence of suicidal ideation emphasize the importance of routine screening for depressive symptomatology in the SCI/D population. Future research should investigate the role of the PHQ-2 in clinical decision-making and treatment monitoring.

Original languageEnglish (US)
Pages (from-to)238-244
Number of pages7
JournalJournal of Spinal Cord Medicine
Issue number2
StatePublished - Mar 4 2018


  • Depression
  • Patient Health Questionnaire
  • Screening
  • Spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology


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