Musculoskeletal care · 2025
Diagnostic and Clinical Utility of the 2-Item Patient Health Questionnaire (PHQ-2) for Screening Depressive Symptoms in Individuals With Persistent Musculoskeletal Pain Attending Physiotherapy.
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Vancampfort Davy, McGrath Ryan L, Dankaerts Wim, Van Assche Dieter, Lambrechts Monica, Stubbs Brendon, Van Damme Tine
Аннотация
INTRODUCTION: This cross-sectional study evaluates the diagnostic and clinical utility of the two-item Patient Health Questionnaire (PHQ-2) for screening depressive symptoms in individuals with persistent musculoskeletal pain attending physiotherapy.
METHODS: A total of 450 patients (mean age = 53.3 ± 12.2 years; 109 male) with persistent musculoskeletal pain were recruited from 84 private physiotherapy practices. Participants completed both the PHQ-9 and PHQ-2. Internal consistency was assessed using Cronbach's alpha. Receiver operating characteristic curve analysis and Youden's J identified the optimal PHQ-2 cutoff score. Chi-square tests examined physiotherapists' intentions to provide advice or refer patients based on PHQ-2 scores.
RESULTS: Internal consistency was good for the PHQ-9 (α = 0.85) and acceptable for the PHQ-2 (α = 0.71). A strong correlation was found between PHQ-2 and PHQ-9 scores (r = 0.51, p < 0.001). PHQ-2 showed moderate accuracy for detecting significant depressive symptoms (AUC = 0.74, 95% CI: 0.70-0.78). A cutoff score of ≥ 1 balanced sensitivity (74%) and specificity (62%). Physiotherapists were more likely to provide advice (85.9% vs. 72.9%, χ2(1) = 11.1, p < 0.001) and recommend additional support (45.8% vs. 18.8%, χ2(1) = 30.6, p < 0.001) when patients scored at or above this cutoff.
DISCUSSION: PHQ-2 is a brief, clinically useful tool with acceptable psychometric properties for screening depressive symptoms in patients with persistent pain in physiotherapy settings.
CONCLUSIONS: PHQ-2 shows promise as a quick screening tool to identify patients with musculoskeletal pain who may need mental health support.
METHODS: A total of 450 patients (mean age = 53.3 ± 12.2 years; 109 male) with persistent musculoskeletal pain were recruited from 84 private physiotherapy practices. Participants completed both the PHQ-9 and PHQ-2. Internal consistency was assessed using Cronbach's alpha. Receiver operating characteristic curve analysis and Youden's J identified the optimal PHQ-2 cutoff score. Chi-square tests examined physiotherapists' intentions to provide advice or refer patients based on PHQ-2 scores.
RESULTS: Internal consistency was good for the PHQ-9 (α = 0.85) and acceptable for the PHQ-2 (α = 0.71). A strong correlation was found between PHQ-2 and PHQ-9 scores (r = 0.51, p < 0.001). PHQ-2 showed moderate accuracy for detecting significant depressive symptoms (AUC = 0.74, 95% CI: 0.70-0.78). A cutoff score of ≥ 1 balanced sensitivity (74%) and specificity (62%). Physiotherapists were more likely to provide advice (85.9% vs. 72.9%, χ2(1) = 11.1, p < 0.001) and recommend additional support (45.8% vs. 18.8%, χ2(1) = 30.6, p < 0.001) when patients scored at or above this cutoff.
DISCUSSION: PHQ-2 is a brief, clinically useful tool with acceptable psychometric properties for screening depressive symptoms in patients with persistent pain in physiotherapy settings.
CONCLUSIONS: PHQ-2 shows promise as a quick screening tool to identify patients with musculoskeletal pain who may need mental health support.