Objective: A recent study identified that a cut-off score >5 on the Patient Health Questionnaire (PHQ-9) had greater sensitivity and specificity to detect DD in teens with T1D than the normative cut-off score. Still, limited provider training or capacity to intervene on a suicide screening item (item 9) leads some clinics to omit item 9. We examined the ideal cut-off score to detect DD in teens with T1D using the modified PHQ-8 screener, and if removing item 9 impacts sensitivity.
Methods: Teens (N=100; Mean age = 15.0 ± 1.7; 60% Male; 87% White; Mean HbA1c = 8.88 ± 1.8%) completed the PHQ-8 electronically. We used the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS DSM-5) depression module to determine if the teen met criteria for DD. We compared teens’ PHQ-8 cut-off scores (PHQ-8 ≥ 10) to KSADS results.
Results: Per KSADS, 15% of teens met criteria for current DD. The PHQ-8 demonstrated low sensitivity (.20) to detect DD using a normative cut-off score, but an adjusted cut-off score >5 increased sensitivity (.87) while maintaining good specificity (.80) (Table 1).
Conclusions: Using a lower cut-off score of >5 on the PHQ-8 can more reliably identify DD in teens with T1D and matches previous PHQ-9 sensitivity and specificity metrics. This suggests removing item 9 does not negatively impact DD screening accuracy, although clinics should consider alternative methods to screen for suicide risk.
S.R.Patton: None. A.Marker: None. R.Mcdonough: None. M.A.Clements: Consultant; Glooko, Inc., Research Support; Dexcom, Inc., Abbott Diabetes.
