Submission Type

Original Research


Introduction: To determine whether the Electronic Pre-participation Physical Examination (EPPE), a proprietary and frequently used tool, is an effective method for depression and anxiety screening in the collegiate athlete population as compared to the Patient Health Questionnaire-4 (PHQ-4).

Methods: College athletes at a Division III university completed PHQ-4 questionnaires and a proprietary EPPE. Positive reponse rates to depression and/or anxiety for both questionnaires were collected and analyzed with a kappa (κ) statistic.

Results: Among 420 students, we found that 9 (2%) reported depression and/or anxiety via the EPPE. Of the 26 students (6%) who answered positively on the PHQ-4, we found that 2 reported depression and/or anxiety on the EPPE. Of the 9 students who reported a history of depression and/or anxiety on the EPPE, we found that 2 scored positively on the PHQ-4. Agreement between the 2 methods was poor (κ = 0.08).

Discussion: Reporting depression or anxiety among collegiate athletes with the EPPE screening question related to the nervous system is low compared to the PHQ-4.

Conclusions: Colleges should consider adding additional depression and anxiety screening tools during the pre-participation exam to ensure they identify and treat at-risk student athletes.



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