Sequential screening for depression in humanitarian emergencies: a validation study of the Patient Health Questionnaire among Syrian refugees

This study utilized data from a cross-sectional survey done with Syrian refugees in a camp in Greece. The goal was to determine if a sequential screening process would be able to accurately assess the number of patients with major depressive disorder (MDD) in the population. While the initial data was collected through the eight-item Patient Health Questionnaire (PHQ-8), this validation study simulated the use of the two-item Patient Health Questionnaire (PHQ-2) as well. The PHQ-2 was used to first screen the data of patients who scored less than 2 on the PHQ-2, who were then ruled out for MDD symptoms. The other patients’ answers were then used in the PHQ-8. The findings were analyzed to see if the two-part process would be able to accurately and efficiently determine who would be most at risk for symptoms of MDD. 

The conclusion of this study was that “The benefits of the sequential screening approach for the classification of MDD presented here are twofold: preserving classification accuracy relative to the PHQ-2 alone while reducing the response burden of the PHQ-8. This sequential screening approach is a pragmatic strategy for streamlining MDD surveillance in humanitarian emergencies.” 

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