Which depression screening statement is most accurate in primary care?

Which depression screening statement is most accurate in primary care?

• A. Beck Depression Inventory is used in screening in all cases.
• B. Hamilton Depression Rating Scale is the only tool used in primary care.
• C. PHQ-2 is sufficient as a standalone diagnostic tool.
• D. PHQ-9 is a primary screening tool for depression; PHQ-2 can be used as an initial screen; positives require clinical assessment.

Answer: (D)

In primary care, depression screening works best when you use brief, validated tools that can be done quickly and then guide next steps. The PHQ-2 is a two-question screen derived from the PHQ-9 that asks about depressed mood and loss of interest over the past two weeks; it’s designed to flag potential cases without taking long. If the PHQ-2 is positive, the next step is to administer the full PHQ-9, which covers the full range of depressive symptoms and also provides a sense of severity. The PHQ-9 can be used as the main screening instrument and, importantly, as a tool to monitor how patients respond to treatment over time. Therefore, the best approach is to use PHQ-9 as a primary screening tool for depression; PHQ-2 can be used as an initial screen; positives require clinical assessment to confirm diagnosis and plan treatment. Other tools listed aren’t as suitable for routine screening in primary care: the Beck Depression Inventory is longer and less practical for universal screening, and the Hamilton Depression Rating Scale is typically used in research or specialty settings rather than primary care. Also, PHQ-2 alone cannot diagnose depression; it’s a screen that triggers further evaluation.

In primary care, depression screening works best when you use brief, validated tools that can be done quickly and then guide next steps. The PHQ-2 is a two-question screen derived from the PHQ-9 that asks about depressed mood and loss of interest over the past two weeks; it’s designed to flag potential cases without taking long. If the PHQ-2 is positive, the next step is to administer the full PHQ-9, which covers the full range of depressive symptoms and also provides a sense of severity. The PHQ-9 can be used as the main screening instrument and, importantly, as a tool to monitor how patients respond to treatment over time. Therefore, the best approach is to use PHQ-9 as a primary screening tool for depression; PHQ-2 can be used as an initial screen; positives require clinical assessment to confirm diagnosis and plan treatment.

Other tools listed aren’t as suitable for routine screening in primary care: the Beck Depression Inventory is longer and less practical for universal screening, and the Hamilton Depression Rating Scale is typically used in research or specialty settings rather than primary care. Also, PHQ-2 alone cannot diagnose depression; it’s a screen that triggers further evaluation.