Insights Provided by Depression Screening Regarding Pain, Anxiety, and Substance use in a Veteran Population.
anxiety
co-occurring
depression
pain
screening tool
veterans
Journal
Journal of primary care & community health
ISSN: 2150-1327
Titre abrégé: J Prim Care Community Health
Pays: United States
ID NLM: 101518419
Informations de publication
Date de publication:
Historique:
entrez:
11
8
2020
pubmed:
11
8
2020
medline:
25
6
2021
Statut:
ppublish
Résumé
We sought to quantify the extent to which a depression screening instrument commonly used in primary care settings provides additional information regarding pain interference symptoms, anxiety, and substance use. Veterans Aging Cohort Study (VACS) data collected from 2003 through 2015 was used to calculate odds ratios (OR) for associations between positive depression screening result cutoffs and clustering conditions. We assessed the test performance characteristics (likelihood ratio value, positive predictive value, and the percentage of individuals correctly classified) of a positive Patient Health Questionnaire (PHQ-9 & PHQ-2) depression screen for the identification of pain interference symptoms, anxiety, and substance use. A total 7731 participants were included in the analyses. The median age was 50 years. The PHQ-9 threshold of ≥20 was strongly associated with pain interference symptoms (OR 21.6, 95% CI 17.5-26.7) and anxiety (OR 72.1, 95% CI 52.8-99.0) and yielded likelihood ratio values of 7.5 for pain interference symptoms and 21.8 for anxiety and positive predictive values (PPV) of 84% and 95%, respectively. A PHQ-9 score of ≥10 still showed significant associations with pain interference symptoms (OR 6.1, 95% CI 5.4-6.9) and symptoms of anxiety (OR 11.3, 95% CI 9.7-13.1) and yet yielded lower likelihood ratio values (4.36 & 8.24, respectively). The PHQ-9 was less strongly associated with various forms of substance use. Depression screening provides substantial additional information regarding the likelihood of pain interference symptoms and anxiety and should trigger diagnostic assessments for these other conditions.
Identifiants
pubmed: 32772883
doi: 10.1177/2150132720949123
pmc: PMC7418233
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2150132720949123Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR002245
Pays : United States
Organisme : NIAAA NIH HHS
ID : K01 AA029042
Pays : United States
Organisme : NIDA NIH HHS
ID : P30 DA011041
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA024706
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020790
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020799
Pays : United States
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