Screening Tool For Depression Research Articles

Expanding the screening toolbox to promote athlete health: how the US Olympic & Paralympic Committee screened for health problems in 940 elite athletes

AimTo assess the value of including validated screening tools for allergies, anxiety, depression, sleep apnoea and sleep quality into an electronic patient health history questionnaire.MethodsIn this descriptive study, we reviewed...

Addressing the mental health needs of children affected by HIV in Rwanda: validation of a rapid depression screening tool for children 7\u201314\u2009years old

BackgroundDepression in children presents a significant health burden to society and often co-exists with chronic illnesses, such as human immunodeficiency virus (HIV). Research has demonstrated that 10–37% of children and adolescents living with HIV also suffer from depression. Low-and-middle income countries (LMICs) shoulder a disproportionate burden of HIV among other health challenges, but reliable estimates of co-morbid depression are lacking in these settings. Prior studies in Rwanda, a LMIC of 12 million people in East Africa, found that 25% of children living with HIV met criteria for depression. Though depression may negatively affect adherence to HIV treatment among children and adolescents, most LMICs fail to routinely screen children for mental health problems due to a shortage of trained health care providers. While some screening tools exist, they can be costly to implement in resource-constrained settings and are often lacking a contextual appropriateness.MethodsRelying on international guidelines for diagnosing depression, Rwandan health experts developed a freely available, open-access Child Depression Screening Tool (CDST). To validate this tool in Rwanda, a sample of 296 children with a known diagnosis of HIV between ages 7–14 years were recruited as study participants. In addition to completing the CDST, all participants were evaluated by a mental health professional using a structured clinical interview. The validity of the CDST was assessed in terms of sensitivity, specificity, and a receiver operating characteristic (ROC) curve.ResultsThis analysis found that depression continues to be a co-morbid condition among children living with HIV in Rwanda. For identifying these at-risk children, the CDST had a sensitivity of 88.1% and specificity of 96.5% in identifying risk for depression among children living with HIV at a cutoff score of 6 points. This corresponded with an area under the ROC curve of 92.3%.ConclusionsThis study provides evidence that the CDST is a valid tool for screening depression among children affected by HIV in a resource-constrained setting. As an open-access and freely available tool in LMICs, the CDST can allow any health practitioner to identify children at risk of depression and refer them in a timely manner to more specialized mental health services. Future work can show if and how this tool has the potential to be useful in screening depression in children suffering from other chronic illnesses.

Validation of brief screening measures for depression and anxiety in young people with substance use disorders

BackgroundIt is critical to promptly identify and monitor mood and anxiety symptoms in young people with SUD. The primary aim of this study was to conduct a psychometric validation of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) for depression and anxiety screening in young people seeking outpatient treatment for SUD. Our secondary aim was to compare the performance of the PHQ-9 and GAD-7 to their briefer two-item versions (PHQ-2 and GAD-2) in terms of detecting probable mood and anxiety disorders. MethodData were extracted from the electronic health records of patients (ages 14 to 26) who received a diagnostic evaluation following clinical implementation of the PHQ-9 and GAD-7 at a hospital-based outpatient SUD treatment program (N=121, average age 19.1 ± 3.1 years). ResultsThe PHQ-9 and GAD-7 showed excellent internal consistency. A PHQ-9 cut score of 7 or 8 (PHQ-2 cut score: 2) and GAD-7 cut score of 6 (GAD-2 cut score: 2) had the best balance of sensitivity, specificity, and positive and negative predictive power in these data. These measures also showed good convergent and acceptable discriminant validity. LimitationsThe sample was predominantly White and non-Hispanic, and a validated (semi-)structured diagnostic interview was not used to establish mood and anxiety disorder diagnoses. ConclusionsResults suggest the PHQ-9 and GAD-7 are reliable and potentially clinically useful screening tools for depression and anxiety in young people with SUD, and that the two-item versions may have similar clinical utility as the full measures.

Holes in the wall: Examining gaps in knowledge in child and adolescent mental health in Tanzania - Scoping review.

To perform scoping review of the existing literature available specific to child and adolescent mental health in Tanzania. An extensive literature search of PubMed, Scopus, MEDLINE and EMBASE was undertaken to identify studies that focussed specifically on mental illness in children and young people in Tanzania. This included neurological and functional disorders, affective disorders, psychosis, epidemiological, intervention and treatment-based studies. Qualitative analysis of the studies was then undertaken to assess what is currently known about the subject and how reliable this information is and to identify areas for further research. Of 23 studies were included in the final synthesis, which could be broadly split into studies focussing on the prevalence and incidence of child and adolescent mental illness, hypothesised causes and correlations, identified treatments and interventions and qualitative studies of human experience. There is a dearth of published research regarding child and adolescent mental health in Tanzania. Although some high-quality studies allow us good insight into the epidemiology of mental illness, interventional studies are often small and low-power, and significant correlational relationships are yet to be drawn. There is significant scope for further child and adolescent mental health research in Tanzania.

Assessing the psychological impact of COVID-19 on intensive care workers: A single-centre cross-sectional UK-based study.

COVID-19 has presented a unique set of psychological stressors for healthcare professionals. There is currently a dearth of literature establishing the impact amongst intensive care workers, who may be at the greatest risk. This study aimed to establish the prevalence of anxiety, depression and post-traumatic stress disorder amongst a cohort of intensive care workers within the United Kingdom. A questionnaire was designed to incorporate validated screening tools for depression (Patient Health Questionnaire, PHQ-9) anxiety (Generalised Anxiety Disorder Scale, GAD-7), and post-traumatic stress disorder (Impact of Event Scale-Revised, IES-R). All intensive care workers at the Countess of Chester Hospital (UK) were eligible. Data was collected between 17th June and 8th July 2020. The majority of the 131 respondents were nurses (52.7% [69/131]) or doctors (32.8% [43/141]). Almost one-third (29.8% [39/131]) reported a significant or extreme impact of COVID-19 on their mental health. In total, 16%(21/131) had symptoms of moderate depression, 11.5%(15/131) moderately severe depression and 6.1%(8/131) severe depression. Females had significantly higher mean PHQ-9 scores than males (8.8 and 5.7 respectively, p = 0.009). Furthermore, 18.3% (24/131) had moderate anxiety with 14.5% (19/131) having severe anxiety. Mean GAD-7 scores were higher amongst females than males (8.7 and 6.3 respectively, p = 0.028). Additionally, 28.2% (37/131) reported symptoms consistent with a diagnosis of PTSD (IES-R ≥ 33). Despite these findings, only 3.1% (4/131) of staff accessed trust mental health support. The impact of COVID-19 on intensive care workers is significant and warrants specific focus and attention in order to preserve this key sector of the workforce.

Comparison of PHQ-9 and PHQ-2 as Screening Tools for Depression and School Related Stress in Inner City Adolescents.

BackgroundMajor depressive disorder is associated with significant morbidity and mortality in adolescents. Suicide is one of the leading causes of mortality between 15 and 19 years. Both AAP and USPSTF recommend routine depression screening of adolescents. Patient Health Questionnaire-2 (PHQ-2) and Patient Health Questionnaire-9 (PHQ-9) are widely used in primary care practice, however, PHQ-2 does not screen for suicidality. School-related factors are known to affect adolescent mental health.PurposeTo compare PHQ-2 and PHQ-9 for depression screening in adolescents, with respect to age, gender, chronic illness over the course of 9 months.MethodsAs a QI initiative, we compared screening results in our inner-city pediatric practice using PHQ-2 and PHQ-9 from Jun’18 to Feb’19. EMR of 2364 patients 12 to 21 years were reviewed. We considered the PHQ-2 score of ≥2 and PHQ-9 of ≥10 as positive. Pre-existing chronic medical and mental illnesses were noted.ResultsOf these 61.5% of patients were females, 95% were Black/Hispanic, and 96% were insured by Medicaid. About 10.6% of PHQ-9 tests were positive whereas 7.4% PHQ2 were positive. Logistic regression was performed to ascertain the effects of age, gender, and chronic illness. Females were more likely to have a positive screen, as were patients with chronic illness. Age had no effect on the outcome. The screening yield for both tests was comparable in the summer months. PHQ9 yield increased while schools were in session while PHQ 2 remained stable.ConclusionPHQ9 is superior as a screening test compared to PHQ2. Repeat screening should be targeted toward patients with chronic medical conditions and/or mental health diagnoses. PHQ9 may be better at screening for school-related stress.

The 5-Item Who Well-Being Index as a Screening Tool for Depression in a Population of Doctors and Nurses in Nigeria during the COVID-19 Pandemic

Background: Undetected depression can result in a significant decline in productivity among the workforce in every system, the healthcare sector inclusive. It is vital to utilize brief screening tools to detect populations at risk of depression. The 5-item WHO Well-being Index (WHO-5) has been used as a screening measure for depression, but research on this is scarce in sub-Saharan Africa. This study aimed to determine the utility and validity of the WHO-5 in screening for depression in a population of doctors and nurses in Nigeria during the COVID-19 pandemic. Methods: A representative sample of medical doctors and nurses across Nigeria (n = 464), completed the 5-item World Health Organization Well-Being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9). Results: The pattern of factors associated with cases of a positive depression screening was considerably similar for the WHO-5 and the PHQ-9. At a cut-off score of 50 for the WHO-5, the sensitivity and specificity values obtained were 0.857 and 0.851 respectively. Positive and negative predictive values were 0.404 and 0.981 respectively. ROC analysis of the WHO-5 against the PHQ-9 revealed that, at a cut-off of 50, the sensitivity of the WHO-5 was 0.857, 1-specificity was 0.152. The AUC was 0.918 (95% CI 0.884-0.953). Also, there was a strong, negative correlation between the WHO and the PHQ-9 scores (r = -0.590, p ≤ 0.0001). Conclusion: The WHO-5 well-being index has satisfactory validity as a screening tool for the detection of depression. It is also feasible for use in very busy settings, because of its brevity and ease of administration.

Systematic Literature Review of Psychiatric Comorbidities in Adults with Epilepsy.

Background and PurposeMental illness is disproportionately common in people with epilepsy (PWE). This systematic literature review identified original research articles that reported the prevalence of psychiatric comorbidities based upon clinical assessments in a sample of PWE and assessed the clinical features of the populations found in studies included in our review of mental health comorbidity.MethodsThe included articles were written in English and published from 2008 to 2018, and focused on adults aged ≥18 years who had psychiatric diagnoses determined in clinical assessments, such as those found in medical records, clinician psychiatric evaluations, structured diagnostic interviews, and mental health screening questionnaires specific for a psychiatric disorder. The primary outcome was the prevalence of psychiatric comorbidities as a percentage of the total sample of PWE. Additional data included the overall sample size, mean age, epilepsy type, study design, and method of diagnosis. A modified Newcastle Ottawa Scale was used to assess the quality of the studies. All 23 articles that were consistent with the inclusion criteria were related to observational studies.ResultsMood disorders and anxiety disorders were the most common psychiatric comorbidities, with prevalence rates of 35.0% and 25.6%, respectively. Major depressive disorder was the most common mood disorder, with a prevalence of 24.2%. Post-traumatic stress disorder (PTSD) had the highest reported prevalence among anxiety disorders, at 14.2%, followed by general anxiety disorder at 11.1%. Other comorbidities included psychosis (5.7%), obsessivecompulsive disorder (3.8%), schizophrenia (1.7%), bipolar disorder (6.2%), and substance abuse (7.9%). The pooled prevalence of suicidality, as reported for two studies, was 9.3%. Temporal lobe epilepsy (TLE) was associated with higher levels of psychiatric comorbidity. Two (8.7%) of the 23 studies compared psychiatric comorbidities in TLE with that of extratemporal lobe epilepsy (ETLE), and one of these two studies found that depression was more common in TLE (53.8%) than in ETLE (25%). Regarding seizure types, partial seizures were associated with a higher prevalence of depression vs generalized seizures.ConclusionsThis systematic literature review of recent original research found a relatively high prevalence of mental health comorbidities in PWE. Mood and anxiety disorders are the most common comorbidities, while psychotic spectrum conditions such as schizophrenia and bipolar disorder are much rarer. The prevalence of comorbidity may vary with the epilepsy type and treatment responsiveness. These findings suggest that screening tools for depression and anxiety should be included as part of the training for epilepsy care, while resources for other relatively common conditions such as PTSD and substance abuse disorders should be readily available to neurology specialists who treat PWE.

P210 COACH project - screening for psychological comorbidity in adolescents with cystic fibrosis

Objectives: Depression and anxiety in patients with cystic fibrosis (CF) have a negative impact on physical health, therapy adherence, and the quality of life of those affected. At the moment there is hardly any research on the optimal and early treatment of these comorbidities. The COACH project (Chronic Conditions in Adolescents: Implementation and Evaluation of Patient-centered Collaborative Healthcare), funded by the German Federal Ministry of Education and Research, aims to identify psychological stress in chronically ill adolescents at an early stage, to gain a better understanding and optimise treatment. Methods: As part of the COACH project, an anxiety and depression screening tool was implemented in the German CF register Mukoweb. Based on the current international guidelines, the evaluated questionnaires PHQ-9 and GAD-7 are completed once a year in participating German clinics by adolescents with CF aged 12 to 21 years and transferred directly to Mukoweb. Patients are then offered the opportunity to participate in further sub-projects, which are intended to improve depressive and anxiety distress by supporting strengths and strategies in coping with their illness. Results: So far, 7 CF centres are participating in the COACH project. Screening was performed in 96 patients with a median age of 16.6 years, 56.3% of which were female. In 19.8% of the patients screened, the result was in the abnormal range with a screening result of PHQ-9 ≥7 or GAD-7 ≥7 (as of Dec 31, 2020). Due to the COVID-19 pandemic restrictions, recruitment has been very delayed in 2020. Conclusion: The first interim results show that one in five of the adolescents with CF examined suffers from anxiety or depression and the care for these comorbidities is of high relevance. Based on the study results of the COACH project, the aim is to raise awareness of Mental Health Screening and to provide evidence-based recommendations for collaborative care of those affected.

Prevalence of anxiety and depression in dizzy patients using Arabic hospital anxiety and depression scale

ObjectivesTo develop an Arabic version of the hospital anxiety and depression scale (HADS) to detect and measure anxiety and depression prevalence in dizzy patients.BackgroundDizziness is a common complaint that has many causes and may be related to psychiatric disorders like anxiety and depression. Early detection of anxiety and depression in dizzy patients helps in proper management and a better outcome. The HADS is a valid screening tool, and having an Arabic version will be of great help.Patients and methodsThe original English HADS was translated following the cross-cultural adaptation guidelines into Arabic. The final Arabic version of HADS was administered to samples of 100 healthy control persons, 30 anxious patients, and 30 depressed patients. Reliability and validity of the translated Arabic HADS were examined. The prevalence of anxiety and depression in dizzy patients were assessed through 100 dizzy patients who were asked to complete the validated Arabic HADS.ResultsThe translated Arabic HADS was found to be reliable with strong internal consistency (Cronbach's alpha was 0.811 for the anxiety group and 0.758 for the depression group). The test–retest reliability was high (Spearman's correlation was 0.980 for the anxiety group and 0.928 for the depression group). There was a good correlation between psychiatric assessment and HADS for anxiety and depression using the Mann–Whitney test, indicating its validity. We performed the receiver operating characteristics curve, and the most sensitive cutoff point for HADS anxiety subscale was 8.5 and for HADS depression subscale was 9.5. In the dizzy group, 32% gave positive HADS scores for anxiety subscale and 22% gave positive HADS scores for depression subscale.ConclusionsThis version of the Arabic HADS is a reliable and valid psychological screening tool for anxiety and depression. The anxiety and depression prevalence in the dizzy patients was 32% and 22%, respectively.

Screening for Depression in People with Kidney Failure.

A large proportion of patients with CKD before and after initiation of maintenance dialysis suffer from major depressive disorder, such that about 20% of those with non-dialysis CKD and 25% of those with kidney failure are affected ([1][1]). More daunting is the actuality, validated in multiple

Risk assessment for postoperative delirium: Cognitive impairment as major factor

AbstractBackgroundElderly patients show an increased risk of postoperative delirium. Cognitive impairment constitutes a risk factor for delirium, whereas delirium can also accelerate cognitive decline. To improve prevention and therapy of delirium, planning of surgical and anaesthetic measures could integrate a range of psychiatric, psychosocial and somatic risk factors. Here, the predictive value of risk factors was investigated.MethodIn a longitudinal design, 120 patients aged 65 years and older were included. Risk factors were assessed before surgical interventions with a questionnaire for risk factors, the TE4D as a screening tool for cognitive impairment and depression and Reisberg’s GDS staging of severity of cognitive impairment. Postoperative prevalence of delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM‐ICU). Pearson correlation was calculated for metric variables. If significant (p<.05), metric variables were transformed into dummy variables by calculating the highest possible odds ratio for delirium. For nominal variables, odds ratio for delirium was calculated. A stepwise binary logistic regression was conducted.ResultPrevalence of postoperative delirium was 13.3%. Results of the Pearson correlation indicated neither significant association between postoperative delirium and age (r(118) = .089, p > .05) nor education (r(118) = ‐.002, p > .05). Postoperative delirium and duration of general anaesthesia were found to be correlated (r(118) = .33, p < .01). Logistic regression of 20 risk factors (Table 1) resulted in a 6‐factor‐model including preoperative cognitive impairment (OR 33.67), severe disease (OR 23.05), premedication with narcotics or benzodiazepine (OR 9), fracture (OR 5.77), duration of general anaesthesia above 160 minutes (OR 5.56) and male gender (OR 2.29). For the resulting model predictive sensitivity was 1, specificity was .93, Youden index J=.93, accuracy .94.ConclusionFor the risk of delirium in elderly surgical patients, preoperative cognitive impairment demonstrated the highest odds ratio followed by somatic predisposition. To decrease the risk of delirium, the result of calculating the risk factors will give the chance to adapt anaesthetic and surgical procedures. A screening tool, working title Computation of Risk for Delirium (COR‐D), including a short version based on the presented data will be provided and further validated.

Effectiveness of a Depression Screening Tool in Obstetrics

The Edinburgh Postnatal Depression Scale (EPDS) is a common screening tool in perinatal care. Previous meta-analyses of this tool included postpartum

GPs\u2019 views on the use of depression screening and GP-targeted feedback: a qualitative study

PurposeThe first aim of this qualitative study was to identify general practitioners’ (GPs’) views on depression screening combined with GP-targeted feedback in primary care. The second aim was to determine the needs and preferences of GPs with respect to GP-targeted feedback to enhance the efficacy of depression screening.MethodsA semistructured qualitative interview was conducted with officially registered GPs in Hamburg (Germany). Interviews were audio recorded and transcribed verbatim. An inductive approach was used to code the transcripts.ResultsNine GPs (27 to 70 years; 5 male) from Hamburg, Germany, participated. Regarding depression screening combined with GP-targeted feedback, five thematic groups were identified: application of screening; screening and patient–physician relationships; GPs’ attitudes towards screening; benefits and concerns related to screening; and GPs’ needs and preferences regarding feedback. While the negative aspects of screening can be described in rather general terms (e.g., screening determines the mental health competence, screening threatens the doctor–patient relationship, revealing questions harm the patients), its advantages were very specific (e.g., promoting the identification of undetected cases, relief of the daily workload, wider communication channel to reach more patients). Standardized GP-targeted feedback of the screening results was perceived as helpful and purposeful. GPs preferred feedback materials that eased their clinical workload (e.g., short text with visuals, pictures, or images).ConclusionAddressing GPs’ needs is essential when implementing depression screening tools in clinical practice. To overcome prejudices and enhance the efficacy of screening, further education for GPs on the purpose and application on depression screening may be needed. Standardized GP-targeted feedback in combination with depression screening could be the missing link to improve the detection of depression in primary care.

Dietary patterns and depression risk in older adults: systematic review and meta-analysis.

Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations. The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults. Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design. Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78-0.92; P < 0.001). There was high heterogeneity (I2 = 64.9%; P < 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity. An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered. PROSPERO registration no. CRD 42020169195.

Rasch validation of the Depression Scale among patients with low back pain

The Depression Scale (DEPS) is a commonly used screening tool for major depression in studies investigating low back pain, yet it has not been validated for patients with back-specific problems. To assess the psychometric properties of the DEPS in patients with degenerative spinal disease. Six hundred and thirty-seven patients with a degenerative spinal disease completed the DEPS instrument. The Rasch Measurement Theory was applied to analyze the measurement properties of the DEPS. The main hypothesis-driven approach was whether the DEPS would meet relevant psychometric criteria for assessing depressive symptoms among patients with degenerative spinal disease. The Mean (SD) DEPS score was 9.2 (6.6). Scale minimum or maximum points among participants were 2.4% and 0.8%, respectively. Cronbach's alpha for internal consistency was 0.92. Person Separation Index for reliability was 0.88. All items had ordered thresholds and seven of the 10 items had good item fit. Unidimensionality of the DEPS was supported (proportion of significant t-tests, 4.5%). This study supports the validity of the DEPS for screening depressive symptoms in patients with degenerative spinal disease.

Depression Screening Tools for Patients with Kidney Failure: A Systematic Review.

Patients with kidney failure experience depression at rates higher than the general population. Despite the Centers for Medicare and Medicaid Services' ESRD Quality Incentive Program requirements for routine depression screening for patients with kidney failure, no clear guidance exists. For this systematic review, we searched MEDLINE, PsycINFO, and other databases from inception to June 2020. Two investigators screened all abstracts and full text. We included studies assessing patients with kidney failure and compared a tool to a clinical interview or another validated tool (e.g., Beck Depression Inventory II). We abstracted data related to sensitivity and specificity, positive and negative predictive value, and the area under the curve. We evaluated the risk of bias using the Quality Assessment of Diagnostic Accuracy Studies 2. A total of 16 studies evaluated the performance characteristics of depression assessment tools for patients with kidney failure. The Beck Depression Inventory II was by far the best studied. A wide range of thresholds were reported. Shorter tools in the public domain such as the Patient Health Questionnaire 9 and Geriatric Depression Scale 15 (adults over 60) performed well but were not well studied. Short tools such as the Beck Depression Inventory-Fast Screen may be a good option for an initial screen. There is limited research evaluating the diagnostic accuracy of most screening tools for depression in patients with kidney failure, and existing studies may not be generalizable to US populations. Studies suffer from limitations related to methodology quality and/or reporting. Future research should target widely used, free tools such as the Patient Health Questionnaire 2 and the Patient Health Questionnaire 9. Systematic Review Registration: PROSPERO CRD42020140227.

Locally contextualizing understandings of depression, the EPDS, and PHQ-9 among a sample of postpartum women living with HIV in Malawi

Background: The Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9) are widely used depression screening tools, yet perceptions and understandings of their questions and of depression are not well defined in cross-cultural research.Methods: 30 postpartum women living with HIV in Malawi were recruited from a cohort study and participated in in-depth cognitive interviews. Transcripts were evaluated following an inductive approach to identify common themes.Results: Participants most frequently described looking sad or different than usual, self-isolation, ‘thinking too much,’ and anger as key symptoms of being depressed. HIV-associated stigma was commonly identified as a cause of depression. The EPDS and PHQ-9 were generally well understood but did not capture all the important symptoms of depression that women described. Participants sometimes requested clarification or rephrasing of certain EPDS and PHQ-9 questions when asked to explain the questions’ meanings in their own words, and requested rephrasing more often for EPDS questions than PHQ-9 questions. Few women believed either tool was sufficient to detect depression.Limitations: Our results may not be generalizable, but are locally contextualized. Women suffering with depression may have been more or less likely to agree to the qualitative interview depending on their comfort level discussing any current depressive symptoms.Conclusions: Researchers and practitioners who use the EPDS and PHQ-9 should be aware of the tools’ limitations in their context and population. New instruments may need to be developed or adaptations to existing tools made to improve accuracy of depression screening and diagnosis in different cultural contexts.

Validation of the Greek version of the distress thermometer compared to the clinical interview for depression

BackgroundThe Distress Thermometer (DT) is worldwide the most commonly used instrument for quick screening of emotional burden in patients with cancer. In order to validate the Greek version of the DT in the Greek population we aimed to explore the capacity of the DT to identify patients with comorbid depressive diagnosis.MethodsWe analyzed the routinely collected clinical data from 152 patients with cancer who had been evaluated by the consultation-liaison psychiatric service and had received a diagnosis of either depressive disorder or no psychiatric diagnosis. The score of the DT accompanied by the list of problems in the Problem List, the depression status, and the clinical and demographic characteristics entered the data sheet.ResultsThe ROC analysis revealed that the DT achieved a significant discrimination with an area under the curve of 0.79. At a cut-off point of 4, the DT identified 85% of the patients with an ICD-10 depressive diagnosis (sensitivity) and 60% of the patients without a psychiatric diagnosis (specificity). The positive predictive value was 44%, the negative predictive value 92% and the diagnostic odd ratio 8.88. Fatigue and emotional difficulties were the most commonly reported problems by the patients.ConclusionThe Greek version of the DT has a sufficient overall accuracy in classifying patients regarding the existence of depressive disorders, in the oncology setting. Therefore, it can be considered as a valid initial screening tool for depression in patients with cancer; patients scoring ≥4 should be assessed by a more thorough mental evaluation.

Validation of the Malay Version of the Hospital Anxiety and Depression Scale among Patients with Traumatic Brain Injury

Introduction: Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross -sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4th Edition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.