Use of the PHQ-4 Tool to Assess Anxiety and Depression in Adolescents and Adults During a Medical Brigade in Medically Underserved Santo Domingo, Ecuador

Anxiety and depression are common yet often underdiagnosed, particularly in underserved populations. In Ecuador, limited access to mental health care heightens this concern. This study assessed the utility of the Patient Health Questionnaire-4 (PHQ-4), a brief screening tool for anxiety and depression, among individuals aged 12 and older during a medical brigade in Santo Domingo, Ecuador in August 2020. A total of 380 participants completed the PHQ-4. Results were analyzed by age, sex, and symptom severity. Pediatric females reported significantly higher anxiety rates than males (35.8% vs 12.5%, P < .05), while depression was more common in females but not statistically significant. Anxiety increased with age, while depression showed no clear trend. Overall, anxiety and depression rates exceeded national estimates for Ecuador. The PHQ-4 effectively identified at-risk individuals, supporting its use in global health settings to screen mental health conditions and guide care in underserved populations.