Screening for suicidality in cancer patients using Item 9 of the nine-item patient health questionnaire; does the item score predict who requires further assessment?

Research paper by Jane J Walker, Christian Holm CH Hansen, Laura L Hodges, Parvez P Thekkumpurath, Mark M O'Connor, Neelom N Sharma, Annet A Kleiboer, Gordon G Murray, Kurt K Kroenke, Michael M Sharpe

Indexed on: 23 Mar '10Published on: 23 Mar '10Published in: General Hospital Psychiatry


To determine whether a higher score on Item 9 of the Patient Health Questionnaire-9 (range zero to three) was more likely to indicate suicidality as determined at subsequent clinical interview in cancer outpatients.Analysis of anonymized data (with ethical approval) obtained from the routine clinical administration of self-report questionnaires and telephone interviews to patients attending a cancer centre in the UK.Complete data were available on 330 patients. Those with higher scores on the item were more likely to be suicidal at interview. However, a substantial number of those (54/235; 23%) who scored only one on the item were also found to be suicidal.A higher score on Item 9 of the PHQ-9 indicates a greater likelihood that the patient is suicidal. However, even patients who score only 1 may be suicidal and consequently also require further assessment.