Rating scales and measurement-based care

Meet the registrar's question

A registrar presents on a ward round: "PHQ-9 is 14, so it's moderate depression — I'll start sertraline." The examiner's follow-up is the whole topic: "What does a PHQ-9 of 14 actually tell you, and what does it not?"^[1]

The honest answer: a PHQ-9 of 14 is a severity metric for depressive symptoms over the past two weeks. It is not a diagnosis, not a risk assessment, and not a substitute for the interview that decides whether this is major depression, bipolar depression, grief, substance use, or a medical mimic.^[1][10]

This page is the instrument literacy that stops a number from masquerading as a diagnosis, plus the MBC loop that turns serial numbers into better care. The biostatistics of sensitivity, specificity, PPV, and ROC live in the sister topic — here we own the scales themselves.^[1][5][10]

References18ShowHide

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17. [17]Lewis CC, Boyd M, Puspitasari A, et al. Implementing Measurement-Based Care in Behavioral Health: A Review JAMA Psychiatry, 2019.PMID 30566197
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