TY - JOUR
T1 - Use of the Patient Health Questionnaire (PHQ-9) in Practice: Interactions between patients and physicians
AU - Ford, Joseph
AU - Thomas, Felicity
AU - Byng, Richard
AU - McCabe, Rose
PY - 2020/11
Y1 - 2020/11
N2 - We analyze the use of nine-item Patient Health Questionnaire (PHQ-9), an instrument that is widely used in diagnosing and determining the severity of depression. Using conversation analysis, we show how the doctor deploys the PHQ-9 in response to the patient’s doubts about whether she is depressed. Rather than relaying the PHQ-9 verbatim, the doctor deviates from the wording so that the response options are selectively offered to upgrade the severity of the patient’s symptoms. This works in favor of a positive diagnosis and is used to justify a treatment recommendation that the patient previously resisted. This contrasted with the rest of the data set, where diagnosis was either not delivered (as patients are presenting with ongoing problems) or delivered without using the PHQ-9. When clinician-administered, the PHQ-9 can be influenced by how response items are presented. This can lead to either downgrading or upgrading the severity of depression.
AB - We analyze the use of nine-item Patient Health Questionnaire (PHQ-9), an instrument that is widely used in diagnosing and determining the severity of depression. Using conversation analysis, we show how the doctor deploys the PHQ-9 in response to the patient’s doubts about whether she is depressed. Rather than relaying the PHQ-9 verbatim, the doctor deviates from the wording so that the response options are selectively offered to upgrade the severity of the patient’s symptoms. This works in favor of a positive diagnosis and is used to justify a treatment recommendation that the patient previously resisted. This contrasted with the rest of the data set, where diagnosis was either not delivered (as patients are presenting with ongoing problems) or delivered without using the PHQ-9. When clinician-administered, the PHQ-9 can be influenced by how response items are presented. This can lead to either downgrading or upgrading the severity of depression.
UR - https://pearl.plymouth.ac.uk/context/pms-research/article/1924/viewcontent/1049732320924625.pdf
U2 - 10.1177/1049732320924625
DO - 10.1177/1049732320924625
M3 - Article
SN - 1049-7323
VL - 30
SP - 2146
EP - 2159
JO - Qualitative Health Research
JF - Qualitative Health Research
IS - 13
ER -