Patient Health Questionnaire-9 and 17-item Hamilton Depression Rating Scale for detecting post-stroke depression in cerebral infarction

Figure 1 Spearman correlation analysis between depression screening scales and International Classification of Diseases, 10^th Revision diagnosis. Both 17-item Hamilton Depression Rating Scale and Patient Health Questionnaire-9 showed strong positive correlations with gold standard diagnosis (rs = 0.762 and 0.718, both P < 0.001). HAMD-17: 17-item Hamilton Depression Rating Scale; ICD-10: International Classification of Diseases, 10^th Revision; PHQ-9: Patient Health Questionnaire-9.

Figure 2 Receiver operating characteristic curves of 17-item Hamilton Depression Rating Scale and Patient Health Questionnaire-9 for diagnosing post-stroke depression. Using International Classification of Diseases, 10^th Revision structured clinical interviews as the gold standard, the diagnostic performance of both scales was evaluated. The area under the curve for 17-item Hamilton Depression Rating Scale (HAMD-17) was 0.891 (95%CI: 0.854-0.928) and for Patient Health Questionnaire-9 (PHQ-9) was 0.867 (95%CI: 0.826-0.908), with no significant difference (Z = 1.426, P = 0.154). The optimal cutoff value for HAMD-17 was 7 points (sensitivity is 88.4%, specificity is 79.8%), and for PHQ-9 was 7 points (sensitivity is 83.0%, specificity is 81.1%). Purple solid line represents HAMD-17, yellow dashed line represents PHQ-9, and black dashed line is the reference line. HAMD-17: 17-item Hamilton Depression Rating Scale; PHQ-9: Patient Health Questionnaire-9.