THU0684 HOW MANY OF YOUR PATIENTS HAVE DEPRESSIVE SYMPTOMS? HOW TO ASSESS DURING ROUTINE CLINICAL PRACTICE?
Authors: Stefan Kleinert, Florian Schuch, Praxedis Rapp, Monika Ronneberger, Joerg Wendler, Matthias Englbrecht
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Patients with rheumatic diseases have a high prevalence of depressive symptoms that affect the patients' self-assessment, adherence to medication [1], and mortality [2]. <h3>Objectives</h3> To evaluate patients with rheumatic diseases regarding depressive symptoms by using the PHQ-2 (Patient Health Questionnaire with 2 items) and assess its feasibility during routine clinical practice. <h3>Methods</h3> 485 consecutive patients with rheumatic diseases attending a rheumatology practice that is part of the public health care system in Erlangen, Germany underwent a routine clinical assessment by different rheumatologists. In addition to disease-specific assessments and questionnaires, every patient answered two questions regarding depressive symptoms which form the PHQ-2 (range of 0[best] to 6[worst]). All questionnaires were answered digitally by touchscreen and Software RheumaDok and RheumaDokM (Nils Körber und Joachim Elgas G.b.R). A PHQ-2 score ≥ 3 points has a sensitivity of 87% and a specificity of 78% for detecting a major depressive disorder compared to a structured clinical interview. [3] A positive screening result was either addressed during subsequent medical consultation or by notifying the patient's general practitioner. The PHQ-2 is a short form of the PHQ-9 which previously had been validated in rheumatoid arthritis. [4]. <h3>Results</h3> Overall, 26% of patients stated depressive symptoms (PHQ score ≥ 3). Table 1 shows the prevalence of depressive symptoms by disease entity which was not significantly different among the subgroups (χ<sup>2</sup>(5)=6, p=0.3). However, given our results indicating depressiveness to be common across subgroups, all of these patients merit further evaluation. The PHQ-2 was widely accepted by patients, and seemed very feasible due to its concise form. <h3>Conclusion</h3> The PHQ-2 questionnaire is a highly feasible and well accepted tool in routine clinical practice, helping to screen for depressive symptoms as a highly prevalent condition across rheumatic diseases. Real world evidence of depressive symptoms may improve healthcare by shedding light on the patients' mental well-being and comorbidity. <h3>References</h3> [1] Brandstetter S, Riedelbeck G, Steinmann M, Loss J, Ehrenstein B, Apfelbacher C. Depression moderates the associations between beliefs about medicines and medication adherence in patients with rheumatoid arthritis: Cross-sectional study. J Health Psychol. 2016 May 04. [2] Kleinert S, Marx A, Faller H, M F, C K, Lehmann S, et al. Prevalence and Relevance of Depressive Symptoms in Patients with Rheumatic Diseases [abstract]. Arthritis Rheumatol 2015; 67 (suppl 10). 2015. [3] Lowe B, Kroenke K, Grafe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res. 2005 Feb; 58(2):163-171.&nbsp; [4] Englbrecht M, Alten R, Aringer M, Baerwald CG, Burkhardt H, Eby N, et al. Validation of Standardized Questionnaires Evaluating Symptoms of Depression inRheumatoid Arthritis Patients: Approaches to Screening for a Frequent Yet Underrated Challenge. Arthritis Care Res (Hoboken). 2017 Jan; 69(1):58-66. <h3>Disclosure of Interests</h3> Stefan Kleinert Grant/research support from: Novartis, Consultant for: Novartis, UCB, Chugai, Celgene, Medac, Roche, Abbvie, Speakers bureau: Novartis, UCB, Chugai, Celgene, Medac, Roche, Abbvie, Florian Schuch Consultant for: Celgene, Lilly, UCB, Roche, Sanofi-Aventis, Abbvie, Novartis, Speakers bureau: Celgene, Lilly, UCB, Roche, Sanofi-Aventis, Abbvie, Praxedis Rapp: None declared, Monika Ronneberger Consultant for: Celgene, Novartis, Paid instructor for: Abbvie, Bristol Myers Squibb, Novartis, Speakers bureau: Celgene, Novartis, Bristol Myers Squibb, Pfizer, Joerg Wendler Consultant for: Roche Pharma AG, AbbVie, Jannssen Cilag, Novartis, Speakers bureau: Roche Pharma AG, AbbVie, Jannssen Cilag, Novartis, Matthias Englbrecht Grant/research support from: Roche Pharma AG, Chugai Pharma Europe Ltd., Consultant for: Roche Pharma AG, Chugai Pharma Europe Ltd., AbbVie Deutschland GmbH &amp; Co. KG, Celgene GmbH, Lilly Deutschland GmbH, Speakers bureau: Roche Pharma AG, Chugai Pharma Europe Ltd., AbbVie Deutschland GmbH &amp; Co. KG, Celgene GmbH, Lilly Deutschland GmbH