The Accuracy of the Patient Health Questionnaire-9 Algorithm for Screening to Detect Major Depression: An Individual Participant Data Meta-Analysis.

Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.

Objective: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.

Barriers to Unmarried Father Involvement During Infancy: Qualitative Study from Professionals' Perspectives.

Introduction Unmarried fathers in the U.S. face barriers to establishing a relationship with their newborn children that married fathers do not confront.

Shortening self-report mental health symptom measures through optimal test assembly methods: Development and validation of the Patient Health Questionnaire-Depression-4.

Background: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria.

Methods: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit.

Psychosocial risk screening of expectant fathers in an urban home visiting service population.

Objective: To examine the occurrence of psychosocial risk factors among expectant fathers whose female partners were enrolled in prenatal home visiting services.

Design: Cross-sectional, exploratory, quantitative design.

Sample: Expectant father-mother pairs were recruited from two urban home visiting programs to participate in a randomized controlled trial of a father advocate intervention.

Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.

Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used.

In-Hospital Paternity Establishment: Experiences and Meaning Perceived by Unmarried Parents.

Voluntary paternity establishment was placed in birthing hospitals by an act of Congress, but little is known about how unmarried parents experience this process. This study presents reactions from 81 racially/ethnically diverse, low-income parents. A qualitative analysis of semi-structured interviews revealed three overall themes and six subthemes: (1) paternity establishment process [subthemes: variety of experiences, strong emotional experience, and poor timing]; (2) meaning of paternity establishment [subthemes: responsible fatherhood, symbol of commitment to child, and importance of the child knowing his father's identity]; and (3) paternity establishment decision-making.

Prenatal care: associations with prenatal depressive symptoms and social support in low-income urban women.

We examined associations of depressive symptoms and social support with late and inadequate prenatal care in a low-income urban population. The sample was prenatal care patients at five community health centers. Measures of depressive symptoms, social support, and covariates were collected at prenatal care entry.

Addressing perinatal depression in a group of underserved urban women: a focus group study.

Background: Perinatal mental health problems are common complications of pregnancy that can go undetected and untreated. Research indicated that mental health complications are more prevalent in women from disadvantaged communities, yet women from these communities often experience barriers to accessing treatments and interventions. Untreated depression during pregnancy can lead to poor self-care, increased substance abuse, poor obstetrical outcomes, developmental delay in children, and increased risk of postpartum depression.

Nurse versus community health worker identification of psychosocial risks in pregnancy through a structured interview.

A structured psychosocial risk screening interview, the Prenatal Risk Overview, was administered to 733 women in prenatal care. Either a community health worker (CHW) or a registered nurse (RN) conducted the interview based on day of the week. A comparison of identified risk factors found no significant differences between study samples for six of 13 domains.

An examination of prenatal and postpartum depressive symptoms among women served by urban community health centers.

We characterized depressive symptoms in the prenatal and/or postpartum periods and examined associated risk factors among 594 women who received care at community health care centers. Women were screened with comprehensive risk assessments, which included the Patient Health Questionnaire-9 depression screen, during pregnancy and at least 4 weeks after delivery. Fifteen percent had depressive symptoms in the prenatal period only; 6 % in the postpartum period only, and 8 % had depressive symptoms in both periods.

Posttraumatic stress disorder among women receiving prenatal care at three federally qualified health care centers.

This study assessed the prevalence and interrelationships of posttraumatic stress disorder (PTSD), antecedent trauma, and psychosocial risk factors among pregnant women served at three urban Federally Qualified Health Care Centers. This analysis was part of a validation study of the prenatal risk overview, a structured psychosocial risk screening interview. The study sample included 745 prenatal patients at three clinics who also were administered the major depression, PTSD, alcohol, and drug use modules of the Structured Clinical Interview for DSM-IV (SCID).

Validity of the prenatal risk overview for detecting drug use disorders in pregnancy.

Objective: To validate the Prenatal Risk Overview (PRO) drug use questions against a structured diagnostic interview among pregnant women.

Design And Sample: Prenatal care patients were administered the PRO at intake and then asked to consent to a research diagnostic interview. Of 1,367 women asked to participate, 1,274 consented and 745 completed the study.

Validation of the Patient Health Questionnaire (PHQ)-9 for prenatal depression screening.

The study was designed to validate the Patient Health Questionnaire (PHQ-9) for depression risk identification among pregnant women. Pregnant women were routinely administered the Prenatal Risk Overview, a comprehensive psychosocial screening interview, which included the PHQ-9, at their prenatal intake appointment at three community clinics. Study participants completed the Structured Clinical Interview for DSM-IV (SCID) at a later appointment.

Validation of the alcohol use module from a multidimensional prenatal psychosocial risk screening instrument.

The purpose of the study was to validate the Prenatal Risk Overview (PRO) Alcohol use domain against a structured diagnostic interview. The PRO was developed to screen for 13 psychosocial risk factors associated with poor birth outcomes. After clinic staff administered the PRO to prenatal patients, they asked for consent to administration of selected modules of the structured clinical interview for DSM-IV (SCID) by a research assistant.

Psychosocial risk screening during pregnancy: additional risks identified during a second interview.

The Prenatal Risk Overview (PRO) screens for 13 psychosocial risk factors associated with poor birth outcomes. This study assessed the extent to which risk factors unreported during an intake interview were identified during a subsequent interview. A total of 708 pregnant women were screened and re-screened at three urban community health care centers between July 2007 and April 2010.

Alcohol and drug use before and during pregnancy: an examination of use patterns and predictors of cessation.

Objectives: This study examines alcohol and nonmedical drug use before and during pregnancy and identifies the predictors of use cessation before the first prenatal visit.

Methods: Data analyses were based on the Prenatal Risk Overview (PRO), a structured interview that screens for psychosocial risk factors associated with poor birth outcomes. The study sample includes 1,492 consecutive prenatal care patients from four urban clinics between November 2005 and June 2007.

The varied circumstances prompting requests for emergency contraception at school-based clinics.

Background: Little is known about the circumstances that prompt teenagers to request emergency contraception (EC). This evaluation was designed to refine the EC clinical protocol and improve pregnancy prevention efforts in high school-based clinics by analyzing information on EC use and subsequent contraception use of EC patients.

Methods: Sites included 5 clinics located at mainstream, racially diverse, and urban high schools.

Systematic prenatal screening for psychosocial risks.

The Prenatal Risk Overview (PRO) was designed to screen for 13 psychosocial risk factors associated with poor birth outcomes. This study describes the development and implementation of the PRO in 4 community health centers. The study also examines the prevalence, co-occurrence, and inter-correlations of psychosocial risks in their prenatal populations.

Mail surveys resulted in more reports of substance use than telephone surveys.

Objective: To determine to what extent the substance-use information obtained in surveys is affected by method of data collection.

Study Design And Setting: Questions on the use of alcohol and drugs were administered to samples of Minnesota adults assigned to one of two conditions to test the effect of mode of administration (mail and telephone); 816 persons completed the survey, roughly one half by mail and one half by telephone.

Results: Those interviewed by telephone revealed more heavy use of alcohol, but the mail sample includes disproportionate numbers of respondents from demographic groups that exhibit less use.

Heightened vulnerability and increased risk-taking among adolescent chat room users: results from a statewide school survey.

Purpose: To profile adolescent Internet chat room users in terms of demographic characteristics, psychological and environmental factors, and behavioral risk factors.

Methods: The study sample was drawn from respondents to an anonymous statewide survey of 50,168 9th-grade public school students and included 40,376 students who reported Internet access at home and 19,511 who accessed chat rooms. Data were collected by the Minnesota Student Survey (MSS), a survey that has been administered triennially by the state's education department to public school students in grades 6, 9, and 12 since 1989.

Evaluating behavioral health services in Minnesota's Medicaid population using the Experience of Care and Health Outcomes (ECHO) Survey.

Performance data on Medicaid managed behavioral health care are for the most part unavailable. The purpose of the current study is to provide a benchmark of Medicaid enrollees' evaluations of access to, and quality of, behavioral health services and to examine the factors that influence these ratings. Eight hundred eighty-five Minnesota Medicaid managed care enrollees who received behavioral health services in 2000 completed the Experience of Care and Health Outcomes Survey, a multidimensional satisfaction survey that included measures of access to services, communication with clinicians, functional improvement, and the effect of treatment.

Differences in behavior, psychological factors, and environmental factors associated with participation in school sports and other activities in adolescence.

This study examined whether participation in school team sports, exclusively or in combination with other extracurricular activities, is associated with higher levels of psychosocial functioning and healthy behavior than participation in other extracurricular activities alone or nonparticipation. The study sample includes 50,168 ninth grade public school students who completed an anonymous, voluntary statewide survey in 2001. Students were classified into four groups based on their participation in sports and other activities (such as clubs, volunteer work, band, choir, or music lessons): neither, both, other activities only, and sports only.