There’s usually a canyon-sized gap between what researchers find in their studies and what goes on in clinical practice, otherwise known as “the real world.”

One of those differences is the simple act of measurement. Most clinicians simply don’t spend a lot of time measuring or worrying about measuring their client’s progress. If this is a problem in the mental health professions, it’s virtually a non-existent exercise in primary care practices. You know, those places where most people actually get their antidepressants.

Why should anyone care about measuring what a person is feeling or experiencing? Well, research has shown that such measurements help a professional keep better track of their patient’s concerns, and whether the current medication is effective or needs to be changed.

Clinicians and physicians both usually answer with the same complaint — I don’t have time to administer such a measure, and besides, nobody pays me to do so.

Well, that’s too bad. Because even something as simple as the Patient Health Questionnaire (PHQ-9) — which is all of nine questions — can help improve patient outcomes.

Duffy et al. (2008) found in a study of 17 diverse psychiatric settings that the administration of the PHQ-9 on a regular basis to their patients resulted in a treatment change in 40% of their clinical contacts. More importantly, the researchers found that the results of this simple 9-question questionnaire influenced their clinical decision making 93 percent of the time.

In addition, in 3 percent of contacts it led the professional to conduct a more thorough suicide risk assessment. This suggests that because of the questionnaire, it’s possible a few lives may have also been saved.

Doctors and therapists regularly argue that there’s no substitute for their own clinical judgment. I’d argue that nobody is looking to replace their clinical judgment, only to supplement it with additional valuable information.

The PHQ-9 takes about 2 minutes to administer and score, and was readily adopted by 17 out of the 19 agencies in the study. It’s a simple measure that more clinicians and doctors should look to administer to their patients on a regular, ongoing basis.

References:

Duffy FF, Chung H, Trivedi M, Rae DS, Regier DA, & Katzelnick DJ. (2008). Systematic use of patient-rated depression severity monitoring: is it helpful and feasible in clinical psychiatry? Psychiatric Services, 59(10), 1148-54.

Patient Health Questionnaire (PHQ-9)

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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Anonymous (2/22/2009)

    Last reviewed: By John M. Grohol, Psy.D. on 22 Feb 2009
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