Evaluation of the Patient Health Questionnaire-2 as a Screening Tool for Depression during the Acute Stroke Admission.
BACKGROUND
The ideal time to screen for poststroke depression remains uncertain. We evaluated the 2-item Patient Health Questionnaire (PHQ-2) as a screening tool for depression during the acute stroke admission by determining the prevalence of positive depression screen during admission and by calculating the level of agreement between positive screens during admission and follow-up.


METHODS
This was a retrospective cohort of adult stroke survivors discharged January to December 2013 with principal discharge diagnosis of acute ischemic stroke or intracerebral hemorrhage. Depression screening was systematically performed during the hospital admission using the PHQ-2. The 9-item Patient Health Questionnaire (PHQ-9), which includes the PHQ-2, was completed by patients at outpatient follow-up.


RESULTS
The study cohort consisted of 337 patients with mean age of 66.3 years. Median time from admission to PHQ-2 was 3 days (interquartile range 1-4 days). The screen was positive for depression in 4.7% (95% confidence interval 2.7%-7.6%) of patients. Of the 150 patients with PHQ-9 data at outpatient follow up, 19.3% screened positive for depression. In both the inpatient setting and at outpatient follow-up, the prevalence of a positive depression screen was similar between patients with and without a history of depression or antidepressant use.


CONCLUSIONS
Systematic screening for depression using PHQ-2 during hospitalization for acute stroke identified few patients. Most patients with depressive symptoms were identified only at the time of outpatient follow-up. Further study is needed to evaluate the usefulness of other depression screens for stroke patients in the acute hospital setting and the optimal timing for depression screening after stroke.
['Shankar|Lakshmi|L|', 'Smith|Nicole|N|', 'Uchino|Ken|K|', 'Thompson|Nicolas R|NR|', 'Pozuelo|Leopoldo|L|', 'Katzan|Irene L|IL|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000928:Antidepressive Agents D015331:Cohort Studies D003863:Depression D005260:Female D006801:Humans D008297:Male D008403:Mass Screening D008875:Middle Aged D000073222:Patient Health Questionnaire D020521:Stroke
depression Stroke hospital admission quality improvement