Use of the Patient Health Questionnaire (PHQ-9) in Practice: Interactions between patients and physicians

Joseph Ford*, Felicity Thomas, Richard Byng, Rose McCabe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

<jats:p> 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. </jats:p>
Original languageEnglish
Pages (from-to)2146-2159
Number of pages0
JournalQualitative Health Research
Volume30
Issue number13
Early online date20 Jun 2020
DOIs
Publication statusPublished - Nov 2020

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