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Cut points on the Patient Health Questionnaire (PHQ-9) that predict response to cognitive–behavioral treatments for depression

Abstract

Objective

Monitoring depressive symptoms during treatment can guide clinical decision making and improve outcomes. The aim of this study was to explore values on the Patient Health Questionnaire (PHQ-9) that could predict response to treatment.

Method

Data came from two independent trials, including three treatment modalities of cognitive-behavioral treatment for depression. Four hundred eighty-seven participants who either met the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria for major depressive disorder or had PHQ-9 scores consistent with a diagnosis of depression were included in our analyses. Participants either received 18 weeks of telephone or face-to-face (n=279) or 8 weeks of Web-delivered (n=208) cognitive-behavioral therapy. Depressive symptoms, evaluated using the PHQ-9, were reported every 4 weeks in the telephone and face-to-face trial and weekly in the Web-delivered intervention trial.

Results

Optimal cut points for predicting end-of-treatment response were consistent in both trials. Our results suggested using cut points of a PHQ-9 ≥17 at Week 4, and PHQ-9 ≥13 at Week 9 and PHQ-9 ≥9 at Week 14.

Conclusions

Consistent cut points were found within the included trials. These cut points may be valuable for algorithms to support clinical decision making.

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