Comparing Approaches to Mobile Depression Assessment for Measurement-Based Care: Prospective Study.
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BACKGROUND To inform measurement based care practice guidelines suggest routine symptom monitoring often on a weekly or monthly basis Increasingly patient provider contacts occur remotely eg by telephone and Web based portals and mobile health tools can now monitor depressed mood daily or more frequently However the reliability and utility of daily ratings are unclear OBJECTIVE This study aimed to examine the association between a daily depressive symptom measure and the Patient Health Questionnaire 9 PHQ 9 the most widely adopted depression self report measure and compare how well these 2 assessment methods predict patient outcomes METHODS A total of 547 individuals completed smartphone based measures including the Patient Health Questionnaire 2 PHQ 2 modified for daily administration the PHQ 9 and the Sheehan Disability Scale Multilevel factor analyses evaluated the reliability of latent depression based on the PHQ 2 for repeated measures between weeks 2 and 4 and its correlation with the PHQ 9 at week 4 Regression models predicted week 8 depressive symptoms and disability ratings with daily PHQ 2 and PHQ 9 RESULTS The daily PHQ 2 and PHQ 9 are highly reliable range 0 80 0 88 and highly correlated r 80 Findings were robust across demographic groups age gender and ethnic minority status Daily PHQ 2 and PHQ 9 were comparable in predicting week 8 disability and were independent predictors of week 8 depressive symptoms and disability though the unique contribution of the PHQ 2 was small in magnitude CONCLUSIONS Daily completion of the PHQ 2 is a reasonable proxy for the PHQ 9 and is comparable to the PHQ 9 in predicting future outcomes Mobile assessment methods offer researchers and clinicians reliable and valid new methods for depression assessment that may be leveraged for measurement based depression care