The 12-month incidence and predictors of PHQ-9-screened depressive symptoms in Chinese primary care patients

Abstract

The 12-month incidence and predictors of PHQ-9 screened depressive symptoms in Chinese primary care patients ABSTRACT Purpose Evidence regarding the onset of depressive symptoms in primary care is rarely available, but can help inform policy development, service planning and clinical decision making. The objective of this study was to estimate the 12-month cumulative incidence and predictors for developing Patient Health Questionnare-9 (PHQ-9) screened depressive symptoms in primary care patients with no prior history of doctor-diagnosed depression. Methods A cohort of 2,929 adult primary care patients with no past history of doctor-diagnosed depression and with PHQ-9 scores ≤ 9 were monitored by telephone interview at 3, 6 and 12 months. A generalized linear mixed effects Poisson Model was used to explore factors associated with incidence of PHQ-positive symptoms. Results The cumulative incidence of PHQ-positive screening over 12 months was 5.23% (95% C.I.: 3.83%-6.64%). Predictors included: being female; coming from a lower income household; being a smoker; having ≥2 co-morbidities; having a family history of depression; having consulted a doctor ≥ twice in the past 4 weeks. Patients who consulted a doctor with qualifications in both Family Medicine and Psychological Medicine had a lower incidence. Conclusions The cumulative incidence of PHQ-9 screened depressive symptoms in this study population was higher than those reported for depressive disorders in earlier systematic reviews. Patients who may warrant greater treatment attention include females, patients with multi-morbidity, smokers, patients with recent high rates of medical consultations, and patients who are from low income households or who have a family history of depression. Doctor training may have a protective effect.