, Volume 22, Issue 1, p 1
Date: 01 Sep 2013

Two-step method of major depression screening by patient health questionnaire for patients with lung cancer

This is an excerpt from the content

To the Editor

I read with interest the recent paper by Randall et al. [1]. They recommended a two-step method for major depression screening using the Patient Health Questionnaire (PHQ) in patients with lung cancer. Before applying the PHQ 9-item version to cancer patients, they applied the PHQ 2-item version as a prescreening tool to avoid wastage of time for patients in the outpatient clinic. In their study, no validation study was conducted by using the Structured Clinical Interview for DSM-IV (SCID) as the gold standard for the diagnosis of major depressive disorder (MDD). The percentage of patients with PHQ-9 scores under 10 was 61 % (8/13) in their study.

I have three concerns about their study. First, PHQ-9 is a screening tool for depression, but mainly for detecting major depressive episode [2], and there are some difficulties in the clinical diagnosis of MDD using the PHQ-9 questionnaire. Randall et al. quoted some references of validation studies including cancer patients. In a