Table 2.

Adjusted Odds Ratios of Depression Screening Administration and Significant Depression among Primary Care Adult Patients Screened for Hazardous Alcohol Use*

CharacteristicOR (95% CI)P valueOR (95% CI)P value
Administered the PHQ-9Significant Depressive Symptoms
Female (reference group, male)1.67 (1.59 to 1.75)<.0011.11 (1.06 to 1.17)<.001
Age, years (reference group, 18 to 39)
    40 to 650.77 (0.73 to 0.81)<.0010.75 (0.72 to 0.78)<.001
    >650.51 (0.45 to 0.57)<.0010.47 (0.43 to 0.51)<.001
Race/ethnicity (reference group, White)
    Asian0.45 (0.42 to 0.48)<.0011.07 (0.98 to 1.16).113
    Black/African American0.75 (0.69 to 0.80)<.0011.55 (1.38 to 1.75)<.001
    Hispanic0.82 (0.78 to 0.87)<.0011.29 (1.20 to 1.40)<.001
    Other/Unknown0.78 (0.75 to 0.81)<.0011.21 (1.13 to 1.30)<.001
Medicaid coverage1.25 (1.15 to 1.36)<.0011.31 (1.15 to 1.48)<.001
Nondepressive/non-SUD mental health diagnosis§1.32 (1.26 to 1.39)<.0010.96 (0.90 to 1.03).310
Charlson comorbidity score0.96 (0.94 to 0.98)<.0011.03 (1.01 to 1.06).003
Weekly alcohol use (reference group: hazardous alcohol use)**
    Abstinent0.72 (0.67 to 0.77)<.0010.84 (0.78 to 0.90)<.001
    Moderate alcohol use††0.70 (0.67 to 0.74)<.0010.71 (0.66 to 0.76)<.001
  • CI, confidence interval; OR, odds ratio; PHQ-9, Patient Health Questionnaire 9; SUD, substance use disorder; ICD-9, International Classification of Diseases, ninth revision.

  • * Logistic generalized estimating equations accounting for patient nested within facility were applied to estimate population-level average effects.

  • Among patients who were administered the PHQ-9 (n = 68,686).

  • Race/ethnicity data were self-reported by patients during their intake evaluation.

  • § Any ICD-9 visit diagnosis code within 1 year prior to the first Alcohol Drinking as a Vital Sign primary care visit that adhered to the following criteria was considered a positive diagnosis: any mental, behavioral and neurodevelopmental disorder (290.XX, 293.XX, 294.XX-302.9, or 306.XX-319), excluding depressive disorders (296.2X, 296.3X, 296.82, 298.0, 300.4, 301.12, 309.0, 309.1, 309.28, or 311), alcohol-related mental disorders (291.XX, 305.0X, or 303.0X), drug-induced mental disorders (292.XX), and nontobacco drug abuse or dependence (305.2X, 305.3X, 305.4X, 305.5X, 306.6X, 305.7X, 305.8X, 305.9X, or 304.XX), where “X” represents any positive integer.

  • ORs correspond to a 1-point increment in the Charlson comorbidity score.

  • ** Patients were asked to estimate alcohol use within the past 90 days; hazardous alcohol use was defined as ≥8 drinks/week for all woman and men ages >65 years and ≥15 drinks/week for men ≤65 years.

  • †† 1 to 7 drinks/week for all woman and men ages >65 years and 1 to 14 drinks/week for men ≤65 years.