Utility of item 9 of the patient health questionnaire in the prospective identification of adolescents at risk of suicide attempt

Introduction Previous studies report that item 9 of the Patient Health Questionnaire (PHQ9) is useful for stratifying risk of suicide attempt in adults. This study re-produced the utility of item 9 of PHQ9 in assessing risk of suicide attempt in adolescents. Materials and Methods Individuals aged 13 to 17 years in 4 health systems with a diagnosis of depression and history of treatment were included. We estimated time to first observed fatal or non-fatal suicide attempt in the 2 years following completion of a PHQ9, stratified by response to item 9. Results There were 51,807 PHQ9 questionnaires for 20,363 youth and 861 instances of suicide attempt. Cumulative probability of suicide attempt ranged from approximately 3.3% (95% CI, 3.0 to 3.5%) for those responding not at all on item 9 to 10.8% (95% CI, 9.2 to 12.4%) for those responding nearly every day. These probabilities are more than 3 times higher than previously reported in adults. Conclusion PHQ item 9 is useful for stratifying risk of suicide attempt in the 2 years following completion of the questionnaire. Monitoring PHQ item 9 over time for patients in treatment for depression can be useful for population health management of adolescents with depression.

Automated summary

This study confirmed the utility of item 9 of PHQ9 in assessing risk of suicide attempt in adolescents. Results showed a significant difference in probability of suicide attempt based on response to item 9, highlighting the importance of long-term monitoring and management for adolescents with depression.