ORCID
- Byng, Richard: 0000-0001-7411-9467
Abstract
We analyze the use of nine-item Patient Health Questionnaire (PHQ-9), an instrument that is widely used in diagnosing and determining the severity of depression. Using conversation analysis, we show how the doctor deploys the PHQ-9 in response to the patient’s doubts about whether she is depressed. Rather than relaying the PHQ-9 verbatim, the doctor deviates from the wording so that the response options are selectively offered to upgrade the severity of the patient’s symptoms. This works in favor of a positive diagnosis and is used to justify a treatment recommendation that the patient previously resisted. This contrasted with the rest of the data set, where diagnosis was either not delivered (as patients are presenting with ongoing problems) or delivered without using the PHQ-9. When clinician-administered, the PHQ-9 can be influenced by how response items are presented. This can lead to either downgrading or upgrading the severity of depression.
DOI
10.1177/1049732320924625
Publication Date
2020-11-01
Publication Title
Qualitative Health Research
Volume
30
Issue
13
ISSN
1049-7323
Embargo Period
2021-10-06
Organisational Unit
Peninsula Medical School
First Page
2146
Last Page
2159
Recommended Citation
Ford, J., Thomas, F., Byng, R., & McCabe, R. (2020) 'Use of the Patient Health Questionnaire (PHQ-9) in Practice: Interactions between patients and physicians', Qualitative Health Research, 30(13), pp. 2146-2159. Available at: https://doi.org/10.1177/1049732320924625
