Assessment Schedule Depression Cards Research Articles

Detecting depression in persons living with mild cognitive impairment: a systematic review.

Depression is common in persons experiencing mild cognitive impairment (MCI), with 32% (95% Cl 27, 37) overall experiencing depression. Persons with MCI who have depression have more cognitive changes compared to those without depression. To understand how we can detect depressive symptoms in persons with MCI, we undertook a systematic review to identify tools that were validated compared with a reference standard. We searched MEDLINE, EMBASE, PsycINFO, and Cochrane from inception to April 25, 2021, and conducted a gray literature search. Title/abstract and full-text screening were completed in duplicate. Demographic information, reference standards, prevalence, and diagnostic accuracy measures were then extracted from included articles (PROSPERO CRD: CRD42016052120). Across databases, 8,748 abstracts were generated after removing duplicates. Six hundred and sixty-five records underwent full-text screening, with six articles included for data extraction. Nine tools were identified compared to a reference standard, with multiple demonstrating a sensitivity of 100% (Brief Assessment Schedule Depression Cards, Beck Depression Inventory-II, Cornell Scale for Depression in Dementia, Zung Self-Rated Depression Scale, and the Neuropsychiatric Inventory). The second highest sensitivity reported was 89% (Patient Health Questionnaire-9). Too few studies were available for a meta-analysis. Multiple depression detection tools have been examined amongst MCI outpatients, with several showing high sensitivity. However, this evidence is only present in single studies, with little demonstration of how differing MCI types affect accuracy. More research is needed to confirm the accuracy of these tools amongst persons with MCI. At this time, several tools could be suitable for use in cognitive clinics.

The Nottingham Fatigue After Stroke (NotFAST) study: results from follow-up six months after stroke

BackgroundPost-stroke fatigue is common and disabling.ObjectivesThe aim of NotFAST was to examine factors associated with fatigue in stroke survivors without depression, six months after stroke.MethodsParticipants were recruited from four UK stroke units. Those with high levels of depressive symptoms (score ≥7 on Brief Assessment Schedule Depression Cards) or aphasia were excluded. Follow-up assessment was conducted at six months after stroke. They were assessed on the Fatigue Severity Scale, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Barthel Index, Beck Anxiety Index, Brief Assessment Schedule Depression Cards, Impact of Event Scale-Revised, and Sleep Hygiene Index.ResultsOf the 371 participants recruited, 263 (71%) were contacted at six months after stroke and 213 (57%) returned questionnaires. Approximately half (n = 109, 51%) reported fatigue at six months. Of those reporting fatigue initially (n = 88), 61 (69%) continued to report fatigue. ‘De novo’ (new) fatigue was reported by 48 (38%) of those not fatigued initially. Lower Nottingham Extended Activities of Daily Living scores and higher Beck Anxiety Index scores were independently associated with fatigue at six months.ConclusionsHalf the stroke survivors reported fatigue at six months post-stroke. Reduced independence in activities of daily living and higher anxiety levels were associated with the level of fatigue. Persistent and delayed onset fatigue may affect independence and participation in rehabilitation, and these findings should be used to inform the development of appropriate interventions.

The Nottingham Fatigue after Stroke (NotFAST) study: factors associated with severity of fatigue in stroke patients without depression

Objective: To identify factors associated with post-stroke fatigue in a sample of stroke survivors without depression. Design: Cross-sectional cohort study. Setting: Recruitment was from four stroke units in the UK. Subjects: Participants were assessed within four to six weeks of first stroke; those with high levels of depressive symptoms (score ⩾7 Brief Assessment Schedule Depression Cards) were excluded. Main measures: Participants were assessed after stroke on the Fatigue Severity Scale of the Fatigue Assessment Inventory, the Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Beck Anxiety Index, Sleep Hygiene Index, 6m walk test, and measures of cognitive ability. Results: Of the 371 participants recruited, 103 were excluded and 268 were assessed. Of the latter, the mean age was 67.7 years (SD 13.5) and 168 (63%) were men. The National Institutes of Health Stroke Scale mean score was 4.96 (SD 4.12). Post-stroke fatigue was reported by 115 (43%) of participants, with 71 (62%) reporting this to be a new symptom since their stroke. Multivariate analysis using the Fatigue Severity Scale as the outcome variable found pre-stroke fatigue, having a spouse/partner, lower Rivermead Mobility Index score, and higher scores on both the Brief Assessment Schedule Depression Cards and Beck Anxiety Index were independently associated with post-stroke fatigue, accounting for approximately 47% of the variance in Fatigue Severity Scale scores. Conclusions: Pre-stroke fatigue, lower mood, and poorer mobility were associated with post-stroke fatigue.

Validation of the Stroke Aphasic Depression Questionnaire using the brief assessment schedule depression cards in an acute stroke sample

To validate the Stroke Aphasic Depression Questionnaire (hospital version: SADQ H10), an observer-rated measure of depression, against the brief assessment schedule depression cards (BASDEC) in acute stroke. This naturalistic audit utilized a cross-sectional design. As part of routine care, 125 patients on an acute in-patient stroke unit were assessed with the BASDEC and SADQ H10. The BASDEC classified 40 patients as depressed and 85 as non-depressed. The SADQ H10 and BASDEC significantly correlated. An ROC (receiver operating curve) analysis showed that the SADQ H10 discriminated between depressed and non-depressed acute stroke patients. The results support the use of the SADQ H10 as a depression screen in acute stroke.

Depression and its relationship with poor exercise capacity, BODE index and muscle wasting in COPD

The prevalence of depression in stable COPD patients varies markedly, possibly because of use of different scales. We aimed to assess depression using 2 different depression scales and to examine the association between depression and poor exercise performance, BODE index and muscle wasting in clinically stable COPD patients. 122 stable COPD patients were assessed with the Centre for Epidemiologic Studies Depression Scale (CES-D) and the Brief Assessment Schedule Depression Cards (BASDEC). We also assessed patients with spirometry, bioelectrical impedance analysis, 6-minute walk distance (6MWD), St George's Respiratory Questionnaire (SGRQ) and MRC dyspnoea and Borg scales. The CES-D and BASDEC scales detected almost similar prevalence rates of depression (21% vs 17%) with a Kappa coefficient of 0.68, p<0.0001. The BASDEC scale detected more depression in women and was more closely associated with dyspnoea than the CES-D. COPD severity was associated with depression when using BODE scores but not when GOLD categories were used. Each of the CES-D and BASDEC depression scores were associated with 6MWD after adjusting for FEV1% predicted, gender, age and pack-years (p = <0.0001 and 0.001, respectively). Also, patients with a 6MWD<350 scored significantly higher on both depression scales. Wasted patients appeared to have higher depression scores, but the difference was statistically insignificant. The administration of different depression scales may affect some of the characteristics of depressed patients rather than the prevalence rate of depression. Depression was associated with poor exercise performance and BODE index in COPD.

A preliminary investigation of the reliability and validity of the Brief Assessment Schedule Depression Cards and the Beck Depression Inventory‐Fast Screen to screen for depression in older stroke survivors

To conduct an initial assessment of the reliability and validity of the Brief Assessment Schedule Depression Cards (BASDEC) and the Beck Depression Inventory-Fast Screen (BDI-FS) to screen for depression in older stroke survivors. Participants from four inpatient rehabilitation units completed the BASDEC and the BDI-FS together with the Hospital Anxiety and Depression Scale (HADS) for comparison. The Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID) was then completed with all participants to ascertain a criterion depression diagnosis. The BASDEC and BDI-FS were subsequently completed for a second time. Forty-nine stroke survivors (M=78.80, SD=6.79 years) were included. The BASDEC and BDI-FS demonstrated acceptable internal consistency and test-retest reliability. The BASDEC (cut-off >or=7) resulted in a sensitivity of 1.0 and specificity of 0.95 for detecting major depression whereas the BDI-FS (cut-off >or=4) had a sensitivity of 0.71 and specificity of 0.74. When participants with minor depression were included in analyses, sensitivity lowered to 0.69 (specificity=0.97) for the BASDEC and 0.62 (specificity=0.78) for the BDI-FS. The BASDEC and BDI-FS were found to have acceptable reliability. The BASDEC demonstrated some advantage in criterion validity over the BDI-FS at the examined cut-offs.

Predictors of 1-year mortality in patients discharged from hospital following acute exacerbation of chronic obstructive pulmonary disease

acute exacerbation of COPD (AECOPD) is a major cause of hospital admission, and predicts subsequent medium-term mortality. We aimed to examine mortality predictors in patients discharged from hospital after AECOPD. we obtained baseline demographic and clinical data from 100 patients (mean age (range)=73 (60-98) years; 48 males) admitted with AECOPD. All completed the following validated questionnaires: a quality of life questionnaire (Breathing Problems Questionnaire; BPQ); a screening questionnaire for depression (Brief Assessment Schedule Depression Cards; BASDEC); a disability questionnaire (Manchester Respiratory Activities of Daily Living questionnaire; MRADL). Following discharge all were prospectively followed and survival/mortality at 12 months confirmed from hospital notes and by contacting general practitioners. the prevalence of depression at recruitment was 56%. One-year mortality in the whole group was 36%. Odds ratios (95% confidence intervals) for mortality predictors (univariate logistic regression analysis) were: use of long-term oxygen therapy=2.72 (1.06-6.97); subsequent readmission=2.57 (1.08-6.12); MRADL score=0.87 (0.80-0.94) (disability predicting death); BASDEC score=1.13 (1.02-1.26) (depression predicting death); BPQ score=1.08 (1.04-1.12) (low quality of life predicting death); length of original hospital stay=1.03 (1.00-1.07). On multivariate logistic regression analysis the only mortality predictor was BPQ with an odds ratio (95% confidence limits) of 1.13 (1.04-1.22). In terms of mortality prediction for individuals, a threshold MRADL score of <12 gave a sensitivity of 86%, specificity of 55%, positive predictive value of 88% and negative predictive value of 52%, with similar predictive values using BPQ as an independent variable. 1-year mortality after AECOPD admission is high. The presence of depressive illness (which is extremely common), and levels of both disability and impairment of quality of life are univariate predictors of 1-year mortality in this patient group. This model may be useful in predicting prognosis for individuals and thus in guiding treatment decisions.

Mortality predictors in disabling chronic obstructive pulmonary disease in old age.

prospectively to evaluate predictors of mortality in elderly patients with disabling chronic obstructive pulmonary disease. 137 (69 men) outpatients, aged 60-89 (mean 73) years with symptomatic disabling chronic obstructive pulmonary disease. We collected baseline demographic and physiological data. Subjects completed the Manchester Respiratory Activities of Daily Living Questionnaire, the Brief Assessment Schedule Depression Cards a screening questionnaire for depression, the Breathing Problems Questionnaire measuring quality of life, and the Montgomery Asberg Depression Rating Scale measuring severity of depression. All subjects were followed prospectively and survival and mortality data were confirmed by contacting general practitioners and scrutinising hospital notes at 30 months. the mean (standard deviation) of one second forced expiratory volume was 0.89 (0.3) litres. At 30 months, 44 patients (21 men, aged 61-89 [mean 75] years: 32% of the total) had died. Mean (standard deviation) baseline one second forced expiratory volume of those dying was 0.71 (0.2) litres. On logistic regression analysis, predictors of mortality were: Manchester Respiratory Activities Of Daily Living Questionnaire score (odds ratio=0.88, 95% confidence interval=0.80-0.97); pre-bronchodilator one second forced expiratory volume (odds ratio=0.04, confidence interval=0.005-0.32); body mass index (odds ratio=0.87, confidence interval=0.79-0.97); and long term oxygen therapy (odds ratio=3.17, confidence interval=1.04-8.36). Current smoking status, pack-years smoked, depression scores, quality of life scores, co-morbid diseases and social class did not predict mortality. disability, use of long-term oxygen therapy, pre-bronchodilator lung function and body-mass index were independent predictors of mortality in elderly patients with severe chronic obstructive pulmonary disease.

Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire.

Depressive and anxiety symptoms are common in elderly patients with chronic obstructive pulmonary disease (COPD). However, true prevalence of clinical depression and anxiety is uncertain. We thus aimed to assess prevalence of clinical depression and/or anxiety in elderly COPD patients using the Geriatric Mental State Schedule (GMS) and determine severity of clinical depression by the Montgomery Asberg Depression Rating Scale (MADRS). We also aimed to validate the Brief Assessment Schedule Depression Cards (BASDEC) screening test for depressive symptoms against GMS. A university teaching hospital. Subjects comprised 137 (69 men) outpatients with COPD, aged 60 - 89 (mean 73) years. Exclusion criteria were acute respiratory exacerbation or use of oral corticosteroid within 6 weeks, known psychosis, acute or chronic confusion. A GMS score > or =3 is diagnostic of clinical depression, and a BASDEC score > or =7 is classed as "case". GMS was taken as gold standard. Severity of depression was assessed by the MADRS: Mean (SD) one second forced expiratory volume was 0.89 (0.3) litres. Sixty-two subjects (46%) scored as a "case" on BASDEC and 57 subjects (42%) were identified as clinically depressed on GMS. In the depressed the prevalence of anxiety was 37% and in the non-depressed 5%. BASDEC performed well against GMS, having a sensitivity of 100%; a specificity of 93%; a positive predictive value of 91% and a negative predictive value of 100%. Assessment of severity of depression by MADRS showed that 17 subjects (30%) were mildly depressed, 39 (68%) were moderately depressed and one (2%) was severely depressed. Clinical depression and anxiety are common in elderly patients with COPD, though clinical anxiety seems mainly confined to those who also suffer clinical depression. Of those depressed, two-thirds scored in the moderately depressed range. BASDEC is a valid screening tool in this patient group.

Depression in elderly outpatients with disabling chronic obstructive pulmonary disease

Depression is common in both young adults and elderly people with chronic obstructive pulmonary disease (COPD). We compared the prevalence of depressive symptomatology in elderly outpatients with stable disabling COPD with that in healthy controls and age-matched patients with other disabilities, and also assessed the relation between degree of disability, quality of life and depressive symptoms. The subjects were 96 older people with COPD [56 men; aged 70-93 (mean 78) years], 55 normal controls [23 men; aged 70-90 (mean 78) years] and 53 disabled controls [27 men; aged 70-92 (mean 78) years]. Exclusion criteria were acute respiratory exacerbation or use of oral steroids in the last 6 weeks, known previous psychiatric disorder and acute or chronic confusion. Mean (and SD) values for 1-s forced expiratory volume (FEV1) were 51 (20) % in COPD subjects, 107 (24) % in normal controls and 82 (13)% in disabled controls. Forty-four subjects with COPD (46%), six normal controls (11%) and 14 disabled controls (26%) scored in the 'caseness' range for depressive ideation on the Brief Assessment Schedule Depression Cards (BASDEC) screening questionnaire. A multiple regression analysis was performed for the COPD group to identify factors predictive of BASDEC score. Predictive variables were total quality of life score [P<0.0001], Chronic Respiratory Questionnaire and level of activities of daily living (Nottingham extended activities of daily living scale) [P = 0.001]. Spirometry results and exercise tolerance (6-min walk distance) did not help predict BASDEC score (R2 = 0.50). Depressive symptoms are common in elderly patients with COPD; prevalence and/or severity of depressive symptoms may be greater in those who are most disabled.

Cognitive impairment, depression and the specificity of autobiographical memory in the elderly.

Previous research has shown that both depressed (Williams & Scott, 1988) and elderly (Winthorpe & Rabbitt, 1988) people have difficulties in being specific in autobiographical memory. However, no study has examined the joint impact of cognitive impairment and affective disturbance. In this preliminary study, 22 elderly people with memory complaints were tested with the Autobiographical Memory Test, the Brief Assessment Schedule Depression Cards, Geriatric Depression Scale and the Mini-Mental State Examination. Results showed that autobiographical specificity decreased with increasing levels of cognitive impairment. Participants were more likely to produce overgeneral memories (omissions or generic memories) than extended or specific memories. There was little relation between severity of depression and specificity in autobiographical memory, consistent with previous suggestions that overgenerality in depression is a long-term cognitive style unaffected by state depression (Brittlebank, Scott, Williams & Ferrier, 1993).

Predictors of Functional Disability in Elderly Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and disability in old age. It leads to reduced functional activities, but factors that contribute to this are less well understood. This study investigated factors that predict functional disability in elderly patients with COPD. A structured questionnaire was used to extract demographic dafa. Subjects performed spirometry and a six-minute walk test and completed the Nottingham Extended Activities of Daily Living Index (NEADL), a depression screening q uestionnaire, the Brief Assessment Schedule Depression Cards (BASDEC), and a disease-specific quality of life questionnaire the Breathing Problems Questionnaire (BPQ). Subjects comprised 96 (56 men) out-patients with COPD, aged 70-93 (mean 78) years. COPD subjects were clinically stable (no hospital admission or

Screening for depression: Clinical validation of geriatricians? diagnosis, The Brief Assessment Schedule Depression Cards and the 5-item version of the Symptom Check List among non-demented geriatric inpatients

In this study, two screening instruments for depression and geriatricians' diagnosis were compared against the Geriatric Mental State Schedule (GMS), a standardized semi-structured psychiatric interview. The Brief Assessment Schedule Depression Cards (BASDEC) achieved 91% sensitivity and 85% specificity using a cutoff score of 7. Its receiver operating characteristics (ROC) had an area under the curve (AUC) of 0.88, with 95% confidence intervals of 0.78 and 0.98. The 5-item version of the Symptom Check List (SCL-5) achieved 77% sensitivity and 74% specificity using a cutoff score of 10. Its AUC was 0.77, with 95% confidence intervals of 0.63 and 0.90. The p-value of the statistical difference between the two AUCs was 0.0554. The geriatricians' diagnosis had a kappa agreement coefficient of 0.39, sensitivity of 55% and specificity of 96%. They missed 45% of depressed patients. Routine screening with BASDEC would considerably improve the detection of depression. Even among those patients who did not appear depressed to the geriatricians, BASDEC would detect one case in every 10 patients.

Screening for depression: Clinical validation of geriatricians’ diagnosis, The Brief Assessment Schedule Depression Cards and the 5-item version of the Symptom Check List among non‐demented geriatric inpatients

Screening for depression: Clinical validation of geriatricians’ diagnosis, The Brief Assessment Schedule Depression Cards and the 5-item version of the Symptom Check List among non‐demented geriatric inpatients

The prevalence of depression in geriatric medical outpatients.

One hundred and fifty-nine patients attending a geriatric medical outpatient clinic were screened for depression using the geriatric depression scale (GDS) and brief assessment schedule depression cards (BASDEC). Twenty-two (13.8%) patients screened positive with one or other test, 13 (8.2%) being positive with both screening tests. There was a highly significant correlation between the two screening tests but the BASDEC instrument was quicker and easier to administer. Eighteen of 22 patients who screened as positive proved to have clinical depression. On subsequent re-testing of 17 of these patients 4-6 weeks later, eight were still positive, but nine patients were now negative and subjectively felt better. These findings suggest the possibility of a transient mood disturbance occurring in elderly patients akin to recurrent brief depression seen in younger subjects, and have implications for starting therapy in apparently depressed elderly people.