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Background <p>Depression is a common but often under-recognized and appreciated comorbidity in patients with acute heart failure (AHF), thereby contributing to poor clinical outcomes and significant healthcare burden. The Patient Health Questionnaire-9 (PHQ-9) is a widely accepted depression screening tool, whereas the shorter Patient Health Questionnaire-2(PHQ-2) offers a rapid alternative suitable in busy clinical scenario. However, evidence supporting the use of PHQ-2 in AHF patients within sub-Saharan Africa remains limited. This study evaluated the agreement and diagnostic accuracy of the PHQ-2 compared with to PHQ-9 and explored sociodemographic factors associated with positive depression screening on the PHQ-2.</p> Methods <p>This cross-sectional study recruited 100 adults admitted for AHF at a tertiary hospital in Ibadan, South West of Nigeria. Participants completed the PHQ-2 and PHQ-9 tools, and probable depression was defined by PHQ-2 ≥ 3 and PHQ-9 ≥ 10. Diagnostic performance metrics were calculated using standard statistical measures. Agreement was assessed with Cohen’s kappa and predictors of positive PHQ-2 screening were identified using logistic regression.</p> Results <p>Prevalence of depression was 19% using the PHQ-2 and 14% using the PHQ-9. PHQ-2 demonstrated high diagnostic performance: sensitivity 78.6%, specificity 96.3%, negative predictive value 98.7%, positive predictive value 57.9%, and area under the ROC curve 0.88 (95% CI: 0.76–1.00). Substantial agreement with PHQ-9 was observed (κ = 0.60, <i>p</i> &lt; 0.001). Although none of the predictors attained statistical significance, low income showed borderline association with positive PHQ-2 screening (aOR = 3.28; <i>p</i> = 0.065).</p> Conclusion <p>PHQ-2 is a valid and efficient screening instrument for depressive symptoms in AHF patients. Its brevity supports routine use to improve early recognition and referral for mental health care, especially in resource-constrained cardiac settings.</p>

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Agreement & Diagnostic Performance of PHQ-2 vs. PHQ-9 in Acute Heart Failure

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Oladimeji Adebayo,
  • Jomiloju Ajiboye,
  • Olufisayo Elugbadebo,
  • Abiodun Adeoye,
  • Akinyemi Aje,
  • Adewole Adebiyi,
  • Oluremi Oladele,
  • Mojisola Abass,
  • Dominic Okoro,
  • Okechukwu S Ogah,
  • Olulola O Oladapo

摘要

Background

Depression is a common but often under-recognized and appreciated comorbidity in patients with acute heart failure (AHF), thereby contributing to poor clinical outcomes and significant healthcare burden. The Patient Health Questionnaire-9 (PHQ-9) is a widely accepted depression screening tool, whereas the shorter Patient Health Questionnaire-2(PHQ-2) offers a rapid alternative suitable in busy clinical scenario. However, evidence supporting the use of PHQ-2 in AHF patients within sub-Saharan Africa remains limited. This study evaluated the agreement and diagnostic accuracy of the PHQ-2 compared with to PHQ-9 and explored sociodemographic factors associated with positive depression screening on the PHQ-2.

Methods

This cross-sectional study recruited 100 adults admitted for AHF at a tertiary hospital in Ibadan, South West of Nigeria. Participants completed the PHQ-2 and PHQ-9 tools, and probable depression was defined by PHQ-2 ≥ 3 and PHQ-9 ≥ 10. Diagnostic performance metrics were calculated using standard statistical measures. Agreement was assessed with Cohen’s kappa and predictors of positive PHQ-2 screening were identified using logistic regression.

Results

Prevalence of depression was 19% using the PHQ-2 and 14% using the PHQ-9. PHQ-2 demonstrated high diagnostic performance: sensitivity 78.6%, specificity 96.3%, negative predictive value 98.7%, positive predictive value 57.9%, and area under the ROC curve 0.88 (95% CI: 0.76–1.00). Substantial agreement with PHQ-9 was observed (κ = 0.60, p < 0.001). Although none of the predictors attained statistical significance, low income showed borderline association with positive PHQ-2 screening (aOR = 3.28; p = 0.065).

Conclusion

PHQ-2 is a valid and efficient screening instrument for depressive symptoms in AHF patients. Its brevity supports routine use to improve early recognition and referral for mental health care, especially in resource-constrained cardiac settings.