Objective: Compare two empirically supported cutoff scores for the Patient Health Questionnaire (PHQ-9) in a clinical sample of youth with type 1 diabetes (T1D). Methods: The sample comprises 212 youth with T1D aged 12–18. We retroactively collected PHQ-9 scores from electronic health records. We compared the normative cutoff score of 10 on the PHQ-9 to a newly modified score of 5. Results: Using the cutoff score of 5 on the PHQ-9, 44.3% of patients screened positive for symptoms of depression, while 22.6% of patients screened positive for symptoms of depression using the cutoff score of 10. Conclusions: The modified cutoff score of 5 on the PHQ-9 resulted in twice as many patients screening positive for symptoms of depression as the normative cutoff score of 10. However, it is important to consider these findings in the context of the healthcare system and the overall impact of false positives.
Implications for Impact Statement
This study found that lowering the PHQ-9 cutoff score to 5 led to twice as many adolescents with type 1 diabetes (T1D) screening positive for symptoms of depression. More research is needed to understand how a modified PHQ-9 affects depression screening in a clinical setting and helps identify youth with T1D and possible depressive symptoms.
