Background: The items of the Patient Health Questionnaire-9 (PHQ-9) represent the criterion symptoms for DSM-IV major depression. This study evaluated the extent to which the PHQ-9 functions as a patient reported outcome measure (PROM) specific to patients with major depressive disorder.

Method: Data were from the Veterans Outcome Assessment survey for 8848 patients beginning treatment in VA general mental health clinics, including 5754, re-surveyed after 3 months. The PHQ-9’s performance as a PROM was evaluated by comparing rank order correlations between both initial scores and improvements over 3 months between the PHQ-9 and several transdiagnostic PROMs across a range of diagnoses and comorbidities. Performance of PHQ-9-related patient reported outcome-based performance measures (PROM-PM) were evaluated by comparing rates of response and remission across patient groups.

Results: Correlations between the PHQ-9 and transdiagnostic measures were significant and comparable in magnitude across a range of diagnoses and for cases with depression with or without comorbidities. Rates of response and remission were comparable across most patient groups.

Limitations: Limitations include use of clinical diagnoses as recorded in health records, and the relatively short time between assessments.

Conclusions: In these settings, the PHQ-9 functions more as a general measure of symptoms or distress than as a disease specific scale. This supports its use as a PROM for patients beyond those with major depression, including those with related diagnoses and those with comorbidities, and use of related PROM-PMs in clinical settings where diagnoses may not be precise and comorbidities may be common.

背景：患者健康问卷 9 (PHQ-9) 的项目代表 DSM-IV 重度抑郁症的标准症状。本研究评估了 PHQ-9 作为患者报告结果测量 (PROM) 特定于重度抑郁症患者的程度。

方法：数据来自退伍军人结局评估调查，对 8848 名在 VA 综合心理健康诊所开始治疗的患者进行了调查，其中 5754 名在 3 个月后再次接受调查。PHQ-9 作为 PROM 的性能是通过比较 PHQ-9 和几个跨诊断 PROM 之间的初始分数和 3 个月内改进之间的等级顺序相关性来评估的，这些相关性包括一系列诊断和合并症。PHQ-9 相关患者报告的基于结果的性能测量 (PROM-PM) 的性能通过比较患者组的反应率和缓解率进行评估。

结 大多数患者组的缓解率和缓解率相当。

局限性：局限性包括使用健康记录中记录的临床诊断，以及评估之间的时间相对较短。

结论：在这些情况下，PHQ-9 的功能更多是作为症状或痛苦的一般测量，而不是作为疾病特定的量表。这支持将其用作重度抑郁症患者以外的 PROM，包括具有相关诊断和合并症的患者，以及在诊断可能不准确且合并症可能很常见的临床环境中使用相关的 PROM-PM。