Latest news with #Perlis
Medscape
18 hours ago
- Health
- Medscape
PHQ-3: A Quick, Yet Still Effective Depression Screen
A shortened version of the commonly used nine-item Patient Health Questionnaire (PHQ-9) may offer clinicians a quicker yet still effective way to screen for depressive symptoms, new research suggested. The PHQ-3 only includes items 1 (about interest), 2 (about depressed mood), and 6 (about self-esteem or failure) from the PHQ-9. In a survey study of more than 96,000 US adult participants, the PHQ-3 had 98% sensitivity and 76% specificity for predicting at least moderate or greater depressive symptoms. Additionally, it was 'highly correlated' with the full PHQ-9 and noninferior to a recently validated four-item version for effectiveness — and it yielded a sensitivity of more than 90% across all ages, races, and ethnicities. Lead study author Roy H. Perlis, MD, vice chair of research in the Department of Psychiatry at Mass General Brigham, Boston, said the investigators wanted to determine the shortest version of the PHQ-9 that could still be effective — and found that the PHQ-3 hit the 'sweet spot' they were looking for. 'We let the data tell us what the constellation of symptoms are that best predict overall severity and how well they do at identifying depression. It's a way we might be able to get the maximum amount of information in the shortest amount of time,' Perlis told Medscape Medical News. However, he noted that he's not yet ready to recommend the PHQ-3 for widespread use in clinical practice. 'I want to see further studies in clinical settings. But I think we made a good start towards showing it did well in a big, general sample of US adults,' Perlis said. The findings were published online on July 21 in JAMA Network Open . Shorter Attention Spans 'The PHQ-9 was not intended as a tool to diagnose depression. It's just a way to start the conversation; and although it's not perfect, it is useful,' Perlis noted. The original patient-reported PHQ was a screen for depression as well as for anxiety, eating disorders, alcohol misuse, and somatization. The version with a nine-item depression scale (PHQ-9) became widely used to screen for depression plus related symptoms, such as fatigue and troubled sleep. However, the length has become burdensome to some patients, especially those who prefer to use phone apps rather than printed out forms. 'Faced with a long list of survey questions, some individuals may be tempted to speed through or to not respond at all,' the investigators wrote. At the recent American Psychiatric Association annual meeting, clinicians in the audience at several sessions mentioned their patients have been complaining that the PHQ-9 is too long and that they prefer data to be delivered in smaller 'chunks.' Perlis said that attitude was a big motivator for their study. 'We're in an era where we have shorter attention spans and people want things very quickly,' he said. 'Personally, I would always rather have the PHQ-9. The question we were trying to answer was: Can we ask fewer questions if we don't have the time or the space to ask about nine [items] and do almost as well?' Perlis reported. The research assessed data from four waves of an online survey conducted from November 2023 to July 2024. In the first wave, they identified the optimal questionnaire items to be included. The four waves had a total of 96,234 participants (57% women; mean age, 47.3 years). Of these, 68% were White individuals, 13% were Black individuals, 10% were Hispanic or Latino individuals, 5% were Asian, and 4% were classified as 'other.' In the full patient population, 26% had moderate or greater depressive symptoms, as measured by a PHQ-9 score ≥ 10. Follow-Up Is Key After examining shortened versions of the PHQ-9 that ranged from including just one item up to eight items, the PHQ-3 with items 1 (interest), 2 (depressed mood), and 6 (self-esteem or failure) was deemed to be the 'optimal' version. It had a sensitivity of 0.98 (95% CI, 0.97-0.98) and a specificity of 0.76 (95% CI, 0.75-0.76) for moderate or greater depressive symptoms. Across all subgroups except participants aged 65 or older, the sensitivity for the PHQ-3 was > 0.94. For that subgroup, it was 0.93. The PHQ-3 was also noninferior to previously reported sensitivity and specificity of the PHQ-Depression-4 in the whole study group and in all subgroups. The area under the receiver operating characteristic curve (AUROC) for predicting moderate or greater depressive symptoms was 0.83 for the PHQ-3. The AUROC for the PHQ-9 was 0.84. 'While a shortened scale cannot capture the full range of the PHQ-9, it may facilitate more widespread and efficient investigation of psychiatric symptoms in general population samples when participant burden and/or data collection expense must be minimized,' the investigators wrote. Overall, Perlis said the PHQ-3 could be a possible first-step screening tool, with more questions added as needed. 'What's most important is that people are screening for depression and, if someone screens positive, that they're following up with a more comprehensive evaluation and offering treatment if it's indicated,' he said. 'It's really about figuring out who needs follow-up.' Menu of Options? In an accompanying editorial, Kurt Kroenke, MD, Regenstrief Institute Indianapolis, noted that the study had 'numerous strengths,' including its large and diverse study population but also several limitations. First, criteria for calculating sensitivity and specificity was not a structured psychiatric interview, which is what was used in the past to evaluate two- and nine-item PHQs. Also, because the researchers pulled from a general population sample, future studies should focus on actual patients from both primary care and psychiatric settings, Kroenke suggested. He noted that in addition to the various shortened PHQs, the two-item and four-item versions of the Patient-Reported Outcomes Measurement Information System have shown benefit. 'Clinicians and researchers looking for ultrashort depression measures now have a menu from which to choose, which is good since one size may not fit all purposes,' Kroenke wrote. 'Expanded use of brief screeners to increase detection of depression has the potential to decrease the burden of the most prevalent mental disorder worldwide,' he added.
Free Malaysia Today
4 days ago
- Politics
- Free Malaysia Today
Zahid warns of a ‘cancer' that could bring down Umno
Umno president Ahmad Zahid Hamidi opening the Arau Umno division's office today. (Bernama pic) ARAU : Umno leaders and members must respond swiftly to issues raised by their detractors to avoid such issues becoming 'a severe cancer that could bring us down', party president Ahmad Zahid Hamidi said today. Zahid said that if such issues are not addressed in a timely manner, they could go viral and affect public perception, regardless of their validity. 'Even if these are repeated or fabricated issues without basis, if left unaddressed, they will become a severe cancer that could bring us down,' he said after visiting the Arau Umno division today. He acknowledged that the party must accept the reality that it has been ineffective in managing issues, thus allowing other parties to win more seats in elections by manipulating public sentiment. 'There are parties that instil cult-like loyalty among their followers. Though their membership is smaller than ours, they secure more seats than we do,' he said. Zahid called on Umno leaders at all levels to deal with arising issues promptly and effectively. At the same time, the party leadership and the members must protect internal unity and party strength, even if faced with differing views and opinions, he said.
Free Malaysia Today
4 days ago
- Politics
- Free Malaysia Today
Govt will take follow-up action on royal addendum, says Zahid
A royal addendum to a pardons board decision on Najib Razak's sentence is currently the subject of a case before the Federal Court. PETALING JAYA : The government will follow-up on a royal order allowing former prime minister Najib Razak to serve the remainder of his prison sentence under house arrest, says deputy prime minister Ahmad Zahid Hamidi. Efforts to act on the matter according to legal procedures will be made as fast as possible, 'but it depends heavily on the powers of the Yang di-Pertuan Agong, which we must all respect,' he told Kangar Umno members at their delegates meeting today in Perlis. He said he has discussed the matter in detail with Prime Minister Anwar Ibrahim, according to a Harian Metro report. Zahid said the legal process would also involve the pardons board, as the king presides over board meetings. Najib is serving a 12-year jail sentence in Kajang prison after being convicted in 2022 of misappropriating RM42 million belonging to SRC International Sdn Bhd. He later applied for a pardon, with the Federal Territories Pardons Board reducing his prison sentence from 12 years to six, and a RM210 million fine to RM50 million. The former prime minister later took the government to court for action to reveal the existence of a royal addendum to the pardons board decision, and to enforce the order allowing him to serve the remainder of his jail sentence under house arrest. The royal addendum is now the subject of an appeal by the government which is being heard by the Federal Court.
Malay Mail
5 days ago
- Politics
- Malay Mail
Zahid: Viral attacks can ‘destroy' Umno if left unanswered
ARAU, July 26 — Umno president Datuk Seri Ahmad Zahid Hamidi has urged the party's leadership and members to respond swiftly to various issues raised by detractors. The deputy prime minister said that if such issues are not addressed in a timely manner, they could go viral and affect public perception, regardless of their validity. 'Even if these are repeated or fabricated issues without basis, if left unaddressed, they will become a severe cancer that could bring us down,' he said when officiating the Arau Umno division office here today. Ahmad Zahid acknowledged that Umno must accept the reality that it has been ineffective in managing issues, which has allowed other parties to win more seats in elections by manipulating public sentiment. 'There are parties that instil cult-like loyalty among their followers. Though their membership is smaller than ours, they secure more seats than we do,' he said. Ahmad Zahid, who is also rural and regional development minister, called on Umno leaders at all levels to deal with arising issues promptly and effectively. At the same time, he urged Umno's leadership and members to protect internal unity and party strength, even if faced with differing views and opinions. — Bernama
Malay Mail
19-07-2025
- Malay Mail
Three Chinese nationals arrested for suspected burglary in Kuala Perlis
KANGAR, July 19 — Three Chinese men were arrested after they were believed to be involved in a housebreaking incident in Taman Bukit Kubu Phase 2, Kuala Perlis near here yesterday involving a loss of about RM4,000. Kangar district police chief ACP Yusharifuddin Mohd Yusop said police received a report at 11.38pm from a man who found that his uncle's house in the area had been broken into. 'Initial investigations found that the house showed signs of a break-in at the back door. Closed-circuit television (CCTV) footage showed three suspects entering the house and taking several valuable items,' he said in a statement today. Yusharifuddin said among the items reported missing were jewellery worth about RM1,200, cash worth RM2,500 from a safe and another RM357 from a drawer in a cupboard in one of the rooms of the house. He said the investigation team from the Kangar Criminal Investigation Division (BSJD) together with the Forensic Unit of the Perlis police contingent headquarters (IPK) also inspected the scene of the incident. He said earlier at 10.10 pm on the same day, police received information from the public that three unknown men were believed to have broken into the house and have been detained by villagers. 'Acting on the information, the arresting officer together with members of the Kuala Perlis police station task force and a MPV team of the Kangar IPD Kuala Perlis Zone went to the location and re-arrested the three men involved. 'The results of the investigation found that they were Chinese nationals aged between 38 and 54 years old who had been in this country for less than a week were looking for work. They were said to have been offered jobs as cooks but have yet to deal with any employers,' he said. Yusharifuddin said further inspection found that the three suspects had valid travel documents and items believed to belong to the victims, including cash and jewellery, were also seized from them. He said the case is being investigated under Section 457 of the Penal Code, which carries a prison sentence of up to five years or a fine or both upon conviction . 'The remand application against the three suspects has been granted for six days starting today by Magistrate Nurshahida Abdul Rahim,' he said. — Bernama
