Diagnostic and Clinical Utility of the 2‐Item Patient Health Questionnaire (PHQ‐2) for Screening Depressive Symptoms in Individuals With Persistent Musculoskeletal Pain Attending Physiotherapy
Year: 2025
Type: article
Study design: Observational Study
Abstract: ABSTRACT Introduction This cross‐sectional study evaluates the diagnostic and clinical utility of the two‐item Patient Health Questionnaire (PHQ‐2) for screening depressive symptoms in individuals with persistent musculoskeletal pain attending physiotherapy. Methods A total of 450 patients (mean age = 53.3 ± 12.2 years; 109 male) with persistent musculoskeletal pain were recruited from 84 private physiotherapy practices. Participants completed both the PHQ‐9 and PHQ‐2. Internal consistency was assessed using Cronbach's alpha. Receiver operating characteristic curve analysis and Youden's J identified the optimal PHQ‐2 cutoff score. Chi‐square tests examined physiotherapists' intentions to provide advice or refer patients based on PHQ‐2 scores. Results Internal consistency was good for the PHQ‐9 ( α = 0.85) and acceptable for the PHQ‐2 ( α = 0.71). A strong correlation was found between PHQ‐2 and PHQ‐9 scores ( r = 0.51, p < 0.001). PHQ‐2 showed moderate accuracy for detecting significant depressive symptoms (AUC = 0.74, 95% CI: 0.70–0.78). A cutoff score of ≥ 1 balanced sensitivity (74%) and specificity (62%). Physiotherapists were more likely to provide advice (85.9% vs. 72.9%, χ 2 (1) = 11.1, p < 0.001) and recommend additional support (45.8% vs. 18.8%, χ 2 (1) = 30.6, p < 0.001) when patients scored at or above this cutoff. Discussion PHQ‐2 is a brief, clinically useful tool with acceptable psychometric properties for screening depressive symptoms in patients with persistent pain in physiotherapy settings. Conclusions PHQ‐2 shows promise as a quick screening tool to identify patients with musculoskeletal pain who may need mental health support.
Source: Musculoskeletal Care
DOI: 10.1002/msc.70113
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4410135072