CCP Depression Screening & PHQ-9 4 — Questions and Answers
Question 1: Compared to the Hamilton Rating Scale for Depression (HAM-D), the PHQ-9 has which key advantage in primary care settings?
- Higher sensitivity for severe depression
- Patient self-administration reducing clinician burden (Correct answer)
- Validated use in inpatient psychiatric units
- Longer recall period of 4 weeks
Correct answer: Patient self-administration reducing clinician burden
The PHQ-9 is patient-self-administered, making it practical for busy primary care settings unlike the clinician-administered HAM-D.
Question 2: What recall period does the PHQ-9 reference for its symptom questions?
- Past 24 hours
- Past 2 weeks (Correct answer)
- Past month
- Past 6 months
Correct answer: Past 2 weeks
PHQ-9 items ask how often the patient has been bothered by each problem 'over the last 2 weeks,' aligning with DSM criteria for major depressive episode.
Question 3: A PHQ-9 score of 5 indicates which level of depression severity?
- Minimal (no depression)
- Mild depression (Correct answer)
- Moderate depression
- Moderately severe depression
Correct answer: Mild depression
The PHQ-9 severity ranges are: 0–4 minimal, 5–9 mild, 10–14 moderate, 15–19 moderately severe, 20–27 severe.
Question 4: Which sensitivity and specificity are closest to the established performance of the PHQ-9 at the ≥10 cutoff for major depression?
- Sensitivity 55%, specificity 65%
- Sensitivity 88%, specificity 88% (Correct answer)
- Sensitivity 70%, specificity 50%
- Sensitivity 99%, specificity 40%
Correct answer: Sensitivity 88%, specificity 88%
At the ≥10 cutoff, the PHQ-9 demonstrates approximately 88% sensitivity and 88% specificity for major depressive disorder.
Question 5: Which DSM-5 criteria domain is NOT directly assessed by an individual PHQ-9 item?
- Depressed mood
- Social withdrawal (Correct answer)
- Sleep disturbance
- Fatigue or loss of energy
Correct answer: Social withdrawal
Social withdrawal is not directly queried as a standalone PHQ-9 item; the tool maps to 8 of the 9 DSM-5 symptom criteria plus a functional impairment item.
Question 6: When monitoring treatment response, how frequently should the PHQ-9 typically be re-administered during active treatment?
- Daily
- Every 4–8 weeks (Correct answer)
- Only at 6-month intervals
- Once at the end of treatment
Correct answer: Every 4–8 weeks
Guidelines recommend reassessing with the PHQ-9 every 4–8 weeks during active treatment to evaluate response and guide adjustments.
Question 7: A patient scores 2 on the PHQ-9. What is the recommended clinical action?
- Initiate antidepressant therapy immediately
- Refer to psychiatry for diagnostic evaluation
- No treatment needed; routine screening per schedule (Correct answer)
- Begin weekly psychotherapy sessions
Correct answer: No treatment needed; routine screening per schedule
A score of 0–4 indicates minimal or no depression; no specific treatment is warranted beyond continuing routine screening.
CCP Depression Screening & PHQ-9 4
Compared to the Hamilton Rating Scale for Depression (HAM-D), the PHQ-9 has which key advantage in primary care settings?