@article {Gjerdingen63, author = {Dwenda Gjerdingen and Scott Crow and Patricia McGovern and Michael Miner and Bruce Center}, title = {Postpartum Depression Screening at Well-Child Visits: Validity of a 2-Question Screen and the PHQ-9}, volume = {7}, number = {1}, pages = {63--70}, year = {2009}, doi = {10.1370/afm.933}, publisher = {The Annals of Family Medicine}, abstract = {PURPOSE Postpartum depression affects up to 22\% of women who have recently given birth. Most mothers are not screened for this condition, and an ideal screening tool has not been identified. This study investigated (1) the validity of a 2-question screen and the 9-item Patient Health Questionnaire (PHQ-9) for identifying postpartum depression and (2) the feasibility of screening for postpartum depression during well-child visits. METHODS Study participants were English-literate mothers registering their 0- to 1-month-old infants for well-child visits at 7 family medicine or pediatric clinics. They were asked to complete questionnaires during well-child visits at 0 to 1, 2, 4, 6, and 9 months postpartum. Each questionnaire included 2 depression screens: the 2-question screen and the PHQ-9. The mothers also completed the depression component of the Structured Clinical Interview for DSM-IV (SCID) initially, and again at a subsequent interval if either screening result was positive for depression. RESULTS The response rate was 33\%. Of the 506 women who participated, 45 (8.9\%) had major depression (ie, they had a positive result on the SCID). The screen sensitivities/specificities over the course of the study were 100\%/44\% with the 2-question screen, 82\%/84\% with the PHQ-9 using simple scoring, and 67\%/92\% with the PHQ-9 using complex scoring. In addition, the corresponding values for the first 2 items of the PHQ-9 (ie, the 2-item Patient Health Questionnaire or PHQ-2) were 84\%/79\%. Some 38\% of women completed their 2- to 6-month questionnaires during well-child visits; the rest completed them by mail (29\%) or telephone (33\%). CONCLUSIONS The 2-question screen was highly sensitive and the PHQ-9 was highly specific for identifying postpartum depression. These results suggest the value of a 2-stage procedure for screening for postpartum depression, whereby a 2-question screen that is positive for depression is followed by a PHQ-9. These screens can be easily administered in primary care clinics; feasibility of screening during well-child visits was moderate but may be better in clinics using a mass-screening approach.}, issn = {1544-1709}, URL = {https://www.annfammed.org/content/7/1/63}, eprint = {https://www.annfammed.org/content/7/1/63.full.pdf}, journal = {The Annals of Family Medicine} }