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Retrospective Rates of Positive Depression Screens in Pediatric Diabetes Using Two PHQ-9 Cutoff Scores: A Brief
Alexandra D Monzon1, Susana R Patton2, Shilpa Gurnurkar3
1Center for Healthcare Delivery Science- Florida, Nemours Children's Health, Orlando, FL, USA.
Clinical Practice in Pediatric Psychology
|June 29, 2026
Summary
A lower cutoff score of 5 on the Patient Health Questionnaire (PHQ-9) identified twice as many adolescents with type 1 diabetes (T1D) experiencing depression symptoms compared to the standard score of 10.
Area of Science:
- Pediatrics
- Psychology
- Endocrinology
Background:
- Type 1 diabetes (T1D) management requires monitoring for mental health conditions like depression.
- The Patient Health Questionnaire (PHQ-9) is a common screening tool for depression.
Purpose of the Study:
- To compare the effectiveness of two cutoff scores (5 and 10) for the PHQ-9 in identifying depression in youth with T1D.
- To evaluate the clinical implications of using a lower PHQ-9 threshold.
Main Methods:
- A retrospective chart review was conducted on 212 adolescents (aged 12-18) diagnosed with T1D.
- PHQ-9 scores were collected from electronic health records.
- The study compared depression screening results using PHQ-9 cutoff scores of 5 versus 10.
Main Results:
- A PHQ-9 cutoff score of 5 identified 44.3% of youth with T1D as positive for depression symptoms.
- The standard PHQ-9 cutoff score of 10 identified 22.6% of youth with T1D as positive for depression symptoms.
- The lower cutoff score of 5 doubled the detection rate of potential depression.
Conclusions:
- A modified PHQ-9 cutoff score of 5 significantly increases the identification of depression symptoms in adolescents with T1D.
- Healthcare providers should consider the implications of false positives and resource allocation when using a lower PHQ-9 cutoff score.
- Further research is needed to validate the clinical utility of the PHQ-9 score of 5 in this population.
