Clinical Utility of the Patient Health Questionnaire-Adolescent in Adolescents With Traumatic Brain Injury

Objective To determine the clinical utility of the Patient Health Questionnaire-Adolescent (PHQ-A) in screening for depressive disorders in adolescents following traumatic brain injury (TBI). Design Retrospective analysis of data collected as a part of routine clinical care over a period of 4 years. Setting Regional rehabilitation facility. Participants Adolescents (n = 101) with mild to moderate-severe TBI who were referred for an outpatient neuropsychological evaluation within 1 to 12 months postinjury. Main outcome measures PHQ-A, PHQ-A_2 (2-item version), and Processing Speed Index (PSI) from the Wechsler scales of intelligence. Results Both premorbid depressive disorder and PHQ-A scores predicted a postinjury diagnosis of depressive disorder, with a combined sensitivity of 0.91 and specificity of 0.59. PHQ-A_2 did not reach acceptable levels of sensitivity in predicting suicidal thoughts. PHQ-A scores did not add significantly to the prediction of PSI results after accounting for TBI severity. Conclusions PHQ-A has clinical utility as a screening instrument for depressive disorders in outpatient adolescents with TBI when the cutoff for clinically significant concern is set at more than 4 and premorbid psychiatric history is also taken into account.