Screening Tool For Depression Research Articles

Validity and Reliability of the Chinese Version of the Edinburgh Postnatal Depression Scale for Fathers of Newborns.

Studies often use the Edinburgh Postnatal Depression Scale (EPDS) or the Beck Depression Inventory-II (BDI-II) as a screening tool for depression in new mothers or fathers following the birth of an infant, but no studies have evaluated EPDS as a predictor of postnatal depression for new fathers in a Chinese population. This study aimed to test the validity and reliability of a Chinese version of the EPDS for fathers of newborns in Taiwan. The study included 368 parents with newborns ≤2 months of age and without any health problems. Construct and criterion-related validities were assessed and Cronbach's alpha was used for measuring internal consistency reliability. The receiver operating characteristic (ROC) curve analyzed the optimal cutoff score for the EPDS. Scores for the Chinese EPDS were significantly higher for fathers who were >34 years of age, employed in a professional occupation, and participated in feeding their infant (p < .05). Mean scores among the fathers for the EPDS and BDI-II were significantly correlated (r = .64, p < .001). The Cronbach's alpha was .83 for the EPDS; ROC curve analysis revealed the optimal cutoff of the EPDS was ≥8 points and the area under the ROC curve was 0.91. The EPDS had good validity and reliability and should therefore be considered suitable for the evaluation of postnatal depression in fathers of newborn infants in Taiwan.

Validation and Comparison of Three Short Depression Screening Tools Among Chinese Community-Dwelling Older Adults.

The current study validated and compared three short Geriatric Depression Scales (GDS), including the GDS-5, D'Ath GDS-4, and van Marwijk GDS-4, among 917 Chinese community-dwelling older adults. The GDS-5, D'Ath GDS-4, and van Marwijk GDS-4 presented satisfactory accuracy against the GDS-15 (area under the curve [AUC] = 0.872 to 0.952), and the GDS-5 and D'Ath GDS-4 had better accuracy than the van Marwijk GDS-4. Satisfactory accuracy (AUC = 0.842 to 0.979) for the three scales was also observed across subgroups by age, sex, education, cognitive function, and multimorbidity. The GDS-5 but not D'Ath GDS-4 and van Marwijk GDS-4 retained a 2-point optimal cutoff for depressive symptoms across subgroups. The GDS-5 (average inter-item correlation coefficient [AIIC] = 0.233) and the D'Ath GDS-4 (AIIC = 0.171) but not van Marwijk GDS-4 (AIIC = 0.128) had acceptable internal consistency. Three scales had stable test-retest reliability within a 1- to 2-week interval (intraclass correlation coefficient = 0.670 to 0.885). The GDS-5 is an accurate and reliable depression screening tool with an invariable optimal cutoff among Chinese community-dwelling older adults. The variable optimal cutoffs for the D'Ath GDS-4 and van Marwijk GDS-4 across subgroups may limit their applicability in this population. [Research in Gerontological Nursing, 15(6), 283-291.].

Final validation of the mental health screening tool for depressive disorders: A brief online and offline screening tool for major depressive disorder.

Early screening for depressive disorders is crucial given that major depressive disorder (MDD) is one of the main reasons of global burden of disease, and depression is the underlying cause for 60% of suicides. The need for an accurate screening for depression with high diagnostic sensitivity and specificity in a brief and culturally adapted manner has emerged. This study reports the final stage of a 3-year research project for the development of depression screening tool. The developed Mental Health Screening Tool for Depressive Disorders (MHS:D) was designed to be administered in both online and offline environments with a high level of sensitivity and specificity in screening for major depressive disorder. A total of 527 individuals completed two versions (online/offline) of the MHS:D and existing depression scales, including the BDI-II, CES-D, and PHQ-9. The Mini International Neuropsychiatric Interview (MINI) for diagnostic sensitivity/specificity was also administered to all participants. Internal consistency, convergent validity, factor analysis, item response theory analysis, and receiver operating characteristics curve (ROC) analysis were performed. The MHS:D showed an excellent level of internal consistency and convergent validity as well as a one-factor model with a reasonable level of model fit. The MHS:D could screen for major depressive disorder accurately (0.911 sensitivity and 0.878 specificity for both online and paper-pencil versions). Item response theory analysis suggested that items from the MHS:D could provide significantly more information than other existing depression scales. These statistical analyses indicated that the MHS:D is a valid and reliable scale for screening Korean patients with MDD with high diagnostic sensitivity and specificity. Moreover, given that the MHS:D is a considerably brief scale that can be administered in either online or paper-pencil versions, it can be used effectively in various contexts, particularly during the pandemic.

Research Unwrapped 2. The Impact Of Covid-19 On Perinatal Mental Health - Part 2

The COVID-19 pandemic is associated with significant increase in the prevalence of anxiety and to a lesser extent depression. Screening tools for depression and anxiety may underestimate the impact of the pandemic on perinatal mental health. There is a need to incorporate more sensitive measures into the screening process for mental illness in the perinatal period.

Building a SW program in a private hem/onc practice: Using the PHQ-9 as a starting point.

266 Background: Hematology/oncology patients historically have high need for social work support. Community practices lack the structure and financial support of hospital practices, often hindering the growth of social work programs. PHQ-9 is a 9-question multipurpose tool for depression screening, diagnosing, monitoring and intervening. This project assessed using the PHQ-9 as a central focus to build a SW program: staff education, EHR automaticity improvement, and enhancement of patient navigation to improve PHQ-9 compliance and patient interventions. Methods: In a multi-office Hem/Onc practice, patients complete the PHQ-9 self-assessment tool, data is entered by MAs, and MD completes an action item according to score. Interventions, which began 1/1/22, included having patients complete the PHQ-9 via a PRO application before visit, interfacing of PRO application with EHR (MA adds score to treatment plan), educating MAs importance of mental health monitoring in health care setting, generating new workflow for MA to send EHR message to SW and notify MD if high score obtained, rapid cycle review of data with MDs, and building out of SW department to accept referrals. Our primary endpoint was % of PHQ-9s completed of those scheduled (every six months). Secondary endpoint was total number of patients internally referred for SW services since 4/1/22 (when psychotherapy services became available). Results: From 7/1/21-12/31/21 (before implementation), of 22,492 visits, 72% had a PHQ-9 reported (with no ongoing monitoring or intervention). From 1/1/22-5/31/22, 88% of 18,655 visits had a PHQ-9 reported. 1,114 patients had a score of 10 or greater on the PHQ-9 between 1/1/22-5/31/22, and of those patients, 100% were assessed for social work intervention. 724 patients were offered referral for mental health services externally; 390 patients have been recommended for internal SW referral (72 have registered for psychotherapy to begin 7/1/22). Conclusions: Our results illustrate the ability to achieve engagement of a SW program in a private practice setting over a limited time by using the PHQ-9 as a primary focus. Education of all staff involved in the process is paramount and will be emphasized when rolling out future components of the SW program: support groups, educational lecture series, and other concrete services.

Depression screening scores for teens with T1D need adjusting

Observing that some depression screening tools can miss cases of depression in teens with diabetes, authors of a new study suggest that adjusted cutoff scores could help better detect depressive disorders in adolescents with Type 1 diabetes.

Diagnosis and Treatment of Depression in Patients with Epilepsy

Depression has not been highlighted in the field of epilepsy research and treatment despite its harmful effects on patients’ daily living. Depression in patients with epilepsy is still underrecognized and undertreated by neurologists due to a lack of training about the psychiatric aspects of neurological disorders, lack of knowledge about the management of depression and the use of antidepressants, lack of time in the outpatient setting, misconceptions about seizure risk with psychotropic medications, and lack of communication with psychiatrists. Therefore, it is critical to acknowledge depression in patients with epilepsy through education and the application of screening tools and establish evidence-based medicine for its treatment. The Neurological Disorders Depression Inventory for Epilepsy is the most efficient and practical screening tool for depression and is also effective to detect suicidality in patients with epilepsy. The International League Against Epilepsy recently provided practical recommendations for the treatment of depression in patients with epilepsy. For mild depression, psychotherapy is the first-line treatment, and where medication is used, selective serotonin reuptake inhibitors (SSRIs) are first-choice medications. For moderate to severe depression, SSRIs remain the first-choice medications and psychotherapy can be combined with antidepressants. Antidepressant treatment should be maintained for at least 6 months following remission from a first depressive episode but it should be prolonged to 9 months in patients with a history of previous episodes and should continue even longer in cases of residual symptomatology until such symptoms have subsided and in those with severe depression. Key words: Epilepsy; Depression; Diagnosis; Antidepressive agents; Psychotherapy.

Validity of the patient health questionnaires (phq-2 and phq-9) for screening depression among human immunodeficiency virus patients in Lahore, Pakistan.

BACKGROUNDMany human immunodeficiency virus (HIV) infected patients suffer from depr-ession, but a little focus is given to detecting and treating depression in primary health care. Detection of depression can be improved by introducing short, reliable, and valid screening instruments.AIMTo determine the psychometric properties of the patient health questionnaire-2 (PHQ-2) and patient health questionnaire-9 (PHQ-9) for depression screening and diagnosis, and the sensitivity and specificity of the PHQ-2 in HIV infected patients.METHODSA cross-sectional study was conducted on 158 HIV-infected patients aged 18 years and above in Lahore, Pakistan. PHQ-2 was implemented to screen depression. PHQ-9 was implemented to diagnose major depressive disorder as a reference standard. Reliability, Validity tests and receiver operating characteristic curve were computed. RESULTSThe Cronbach's alpha of PHQ-2 and PHQ-9 were 0.732 and 0.759, respectively. The study results showed that the score of 2 on PHQ-2 indicates the highest Youden's index of 0.924, with both sensitivity and specificity of 0.96, and the area under the curve for PHQ-2 was 0.98 (95%CI: 0.953-0.998).CONCLUSIONGood psychometric properties for the PHQ-2 and PHQ-9 indicated their significant potential as tools for depression screening and diagnosis in the HIV-infected population.

Physicians’ Awareness of Depression Among Their Patients in Saudi Arabia

BackgroundDepression is a global public health burden, and although it is multifactorial, its development is highly associated with chronic diseases. Thus, physicians’ knowledge and attitude toward depression are vital for the recognition and treatment of depression among patients with chronic illnesses. This study aims to examine physicians’ knowledge and attitude toward depression in Saudi Arabia and to determine factors that significantly influence them.MethodologyAn online survey using a 12-item questionnaire was completed by 50 physicians between January and June 2020. Knowledge (K) and attitude (A) scores were calculated and compared nonparametrically based on scores by gender and years of experience.ResultsParticipants’ years of clinical experience was found to significantly influence the participants’ K scores, with those with fewer than one year of experience having the highest K scores of all participants (p < 0.05). Years of experience had a similar influence on the A scores. Furthermore, gender was an influencing factor as male participants had higher A scores than female participants. Years of experience and gender influenced the A scores independently. Male physicians more commonly referred patients to a mental health specialist than female physicians, and had significantly higher A scores and more years of experience. There was a direct correlation between the K and A score, indicating that participants’ knowledge of depression positively influenced their attitude toward depression.ConclusionsIn this study, participants’ gender and years of experience have been identified to have a significant impact on their knowledge and attitude toward comorbid depression when treating patients with chronic illnesses. This identifies an important gap and offers preliminary insight into the readiness and practice of holistic care for patients, particularly for those treated by physicians of differing gender and experience levels. Findings further demonstrate that it is most beneficial to patients with chronic illnesses that physicians utilize a holistic approach and consider depression when developing their treatment plans. This would involve being able to detect and manage depression among their patients properly, as well as referring patients to mental health specialists when needed. Clinical guidelines should be updated to emphasize the use of depression screening tools for patients with chronic diseases.

Depression prediction using machine learning: a review

Predicting depression can mitigate tragedies. Numerous works have been proposed so far using machine learning algorithms. This paper reviews publications from online electronic databases from 2016 to 2020 that use machine learning techniques to predict depression. The aim of this study is to identify important variables used in depression prediction, recent depression screening tools adopted, and the latest machine learning algorithms used. This understanding provides researchers with the fundamental components essential to predict depression. Fifteen articles were found relevant. We based our review on the systematic mapping study (SMS) method. Three research questions were answered through this review. We discovered that sixteen variables were deemed important by the literature. Not all of the reviewed literature utilizes depression screening tools in the prediction process. Nevertheless, from the five screening tools discovered, the most frequently used were hospital anxiety and depression scale (HADS) and hamilton depression rating scale (HDRS) for general population, while for literature targeting older population geriatric depression scale (GDS) was often employed. A total of twenty-two machine learning algorithms were identified employed to predict depression and random forest was found to be the most reliable algorithm across the publications.

Transparency and completeness of reporting of depression screening tool accuracy studies: A meta-research review of adherence to the Standards for Reporting of Diagnostic Accuracy Studies statement.

Accurate and complete study reporting allows evidence users to critically appraise studies, evaluate possible bias, and assess generalizability and applicability. We evaluated the extent to which recent studies on depression screening accuracy were reported consistent with Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement requirements. MEDLINE was searched from January 1, 2018 through May 21, 2021 for depression screening accuracy studies. 106 studies were included. Of 34 STARD items or sub-items, the number of adequately reported items per study ranged from 7 to 18 (mean=11.5, standard deviation [SD]=2.5; median=11.5), and the number inadequately reported ranged from 3 to 17 (mean=10.1, SD=2.5; median=10.0). There were eight items adequately reported, seven partially reported, 11 inadequately reported, and four not applicable in ≥50% of studies; the remaining four items had mixed reporting. Items inadequately reported in ≥70% of studies related to the rationale for index test cut-offs examined, missing data management, analyses of variability in accuracy results, sample size determination, participant flow, study registration, and study protocol. Recently published depression screening accuracy studies are not optimally reported. Journals should endorse and implement STARD adherence.

Men's Depression, Externalizing, and DSM-5-TR: Primary Signs and Symptoms or Co-occurring Symptoms?

Men's Depression, Externalizing, and DSM-5-TR: Primary Signs and Symptoms or Co-occurring Symptoms?

Applying machine learning methods to psychosocial screening data to improve identification of prenatal depression: Implications for clinical practice and research.

We utilized machine learning (ML) methods on data from the PROMOTE, a novel psychosocial screening tool, to quantify risk for prenatal depression for individual patients and identify contributing factors that impart greater risk for depression. Random forest algorithms were used to predict likelihood for being at high risk for prenatal depression (Edinburgh Postnatal Depression Scale; EPDS ≥ 13 and/or positive self-injury item) using data from 1715 patients who completed the PROMOTE. Performance matrices were calculated to assess the ability of the PROMOTE to accurately classify patients. Probability for depression was calculated for individual patients. Finally, recursive feature elimination was used to evaluate the importance of each PROMOTE item in the classification of depression risk. PROMOTE data were successfully used to predict depression with acceptable performance matrices (accuracy = 0.80; sensitivity = 0.75; specificity = 0.81; positive predictive value = 0.79; negative predictive value = 0.97). Perceived stress, emotional problems, family support, age, major life events, partner support, unplanned pregnancy, current employment, lifetime abuse, and financial state were the most important PROMOTE items in the classification of depression risk. Results affirm the value of the PROMOTE as a psychosocial screening tool for prenatal depression and the benefit of using it in conjunction with ML methods. Using such methods can help detect underreported outcomes and identify what in patients' lives makes them more vulnerable, thus paving the way for effective individually tailored precision medicine.

Diagnostic Evaluation of Depression Screening Tools in Asian New Zealanders.

This study aimed to compare the Kessler Psychological Distress Scale (K10) and Short-Form 12-Item Health Survey Mental Component Score (SF-12 MCS) for the effectiveness as screening tools for depression in Asian New Zealanders. A national, representative New Zealand Health Survey (NZHS) data set was used. In total, 1,277 participants were included in the analyses. The sensitivity and specificity values, as well as the areas under the receiver operating characteristics curves (AUROC), for the K10 and the SF-12 MCS scores were examined. The AUROCs for K10 and SF-12 MCS were 0.787 (95% CI [0.736, 0.837]) and 0.725 (95% CI [0.656, 0.793]), respectively. A less than optimal sensitivity and positive predictive value of K10 support the need to reexamine the optimal cut-off point according to the results of the Youden index. Strengthening the K10 predictive accuracy will increase the practical application among Asian populations.

Correlates of patient-reported cognitive performance with regard to disability

The patient-reported form of the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) assesses perceived problems attributable to cognitive and neuropsychiatric symptoms. It is inconsistently related to objective cognitive performance in multiple sclerosis (MS), while strongly correlated with depression. We assessed whether the relationship between subjective and objective cognitive screening tools is moderated by disability. Furthermore, we investigated the MSNQ as a screening tool for both cognitive impairment and depression. 275 MS patients completed the patient-reported MSNQ, two‐question screening tool for depression and Symbol Digit Modalities Test (SDMT) and were divided into Expanded Disability Status Scale (EDSS) subgroups: Low 0.0–3.0, Medium 3.5–6.0, High 6.5–9.0. MSNQ scores correlated significantly with depression but not SDMT in all subgroups. After correcting for age, sex, education, EDSS and depression, MSNQ significantly predicted SDMT in the total group, but not the subgroups. MSNQ significantly predicted a positive depression and/or cognitive impairment screen in the total group and all subgroups. The relationship between subjective and objective cognitive screening tools is not influenced by physical disability. MSNQ scores are substantially influenced by depression, and reflect cognitive function to some degree. Patient-reported cognitive measures can be useful to identify patients requiring further (neuro)psychological assessment.

Factor Structures of Patient Health Questionnaire-9 Instruments in Exploring Depressive Symptoms of Suburban Population.

BackgroundThis study aims to examine the psychometric properties of the nine-item Patient Health Questionnaire (PHQ-9) and assess the relationship between the PHQ-9 domain and demographics and health behaviors in Vietnamese people.Materials and MethodsThe PHQ9 was administered to 899 participants. Exploratory factor and reliability analyses were performed. Tobit regression and Ordered logistic regression were further performed to determine factors associated with the PHQ-9 score and characteristics of depression.ResultsThe 2-factor model of PHQ-9, including factor 1 “Somatic” and factor 2 “Cognitive/Affective,” showed good psychometric properties. The Cronbach’s alpha value showed high internal consistency in two factors (0.84 and 0.80, respectively). Gender, health behavior exercising, drinking, and health status had associations with both factors of the PHQ-9 model.ConclusionThe PHQ-9 scale is a valid and reliable instrument to assess depression in the Vietnam population. This scale can be a useful screening tool for depression; however, further validation studies in other populations are required.

Validity of the Chinese Language Patient Health Questionnaire 2 and 9: A Systematic Review.

Introduction:Chinese Americans with limited English proficiency have higher mental health needs than English speakers but are more likely to be undiagnosed and undertreated for depression. Increasing anti-Asian hate crimes during the COVID-19 pandemic has increased the urgency to accurately detect depressive symptoms in this community. This systematic review examines the validity of the Patient Health Questionnaire (PHQ)-2/9 for depression screening in Chinese-speaking populations.Methods:We queried PubMed, Web of Science, Embase, and PsycINFO databases, examining studies through September 2021. Studies were included if they evaluated the Chinese language PHQ-2 or PHQ-9 and diagnosed depression using a clinical interview. Two investigators independently extracted study data and assessed quality using the QUADAS-2. Study sensitivities and specificities were combined in random effects meta-analyses.Results:Of 513 articles, 20 met inclusion criteria. All examined the PHQ-9; seven also examined the PHQ-2. Studies were conducted in Mainland China (17), Hong Kong (1), Taiwan (1), and the United States (1). Fourteen studies were published in English; six in Chinese. Studies were diverse in setting, participant age, and comorbidities. For the Chinese language PHQ-9, Cronbach's alpha ranged from 0.765 to 0.938 for included studies (optimal cutoff scores ranged from 6 to 11). For the PHQ-2, Cronbach's alpha ranged from 0.727 to 0.785 (optimal cutoff scores 1–3). Overall, the PHQ-9 pooled sensitivity was 0.88 (95% CI 0.86–0.90), and pooled specificity was 0.87 (95% CI 0.83–0.91). Similarly, the pooled PHQ-2 sensitivity was 0.84 (95% CI 0.80–0.87), and pooled specificity was 0.87 (95% CI 0.78–0.93). The overall risk of bias was low (12 studies) or indeterminate (8 studies).Discussion:While limited by missing study information, the Chinese language PHQ-9 appears to be a valid depression screening tool among Chinese-speaking populations across geographic and clinical settings. Further research should explore optimal cutoff scores for this population for routine depression screening and the validity of the tool to measure response to depression treatment.

Relationship between Edinburg Postnatal Depression Scale (EPDS) Scores in the Early Postpartum Period and Related Stress Coping Characteristics.

Despite postpartum depression being a common mental health problem, there is no screening method for it. The only risk assessment used is the Edinburgh Postnatal Depression Scale (EPDS). We investigated the relationship between Brief Scale for Coping Profile (BSCP) subscales performed during pregnancy and EPDS scores. We recruited 353 women with normal pregnancies (160 primiparas, and 193 multiparas) and performed BSCP at 26 weeks of gestation. The EPDS was first performed within one week after delivery (T1), and then after one month (T2). Spearman’s correlation coefficients were calculated for the BSCP and EPDS for the whole and primi/multipara groups. Multiple regression analysis was performed with the EPDS T2 scores as the dependent variable. The EPDS scores were higher in the primipara group compared to the multipara (p < 0.001), and the EPDS T1 scores were higher than the overall T2 score (p < 0.001). In the multiple regression analysis, EPDS T1 and the “seeking help for solution” subscale were selected as significant explanatory variables when analyzed in the whole group; EPDS T1 and “active solution” for the primiparas; and EPDS T1, “changing mood”, and “seeking help for solution” for the multiparas. The BSCP can be used as a screening tool for postpartum depression during pregnancy.

A Validated Postnatal Depression Screening Tool and Guideline to Improve Evidence-Based Screening for Postpartum Depression in Ambulatory Care

Postpartum depression is one of the most common diagnoses for maternal morbidity and mortality, affecting one in eight women in the United States. Initially, there was no universal process for the identification of postpartum depression in ambulatory clinics in a regional health system caring for obstetric patients, which puts patients and their newborns at risk for severe and potentially detrimental consequences. A quality improvement project was developed and implemented with a pilot group in the ambulatory setting.

A Brief Depression Screening Tool for Perinatal Clinical Practice: The Performance of the PHQ-2 Compared with the PHQ-9.

There is ongoing interest in using brief screening instruments to identify perinatal depression in clinical practice. One ultra-brief screening instrument for depression is the Patient Health Questionnaire-2 (PHQ-2), but thus far its accuracy in perinatal clinical practice has been barely researched. In the present study, we aimed to assess the screening accuracy of the PHQ-2 against the Patient Health Questionnaire-9 (PHQ-9) in a large sample of perinatal women. A total of 1155 consecutive women attending 11 health care centers throughout Italy completed the PHQ-9 (which includes the PHQ-2) during pregnancy (27-40 weeks) or postpartum (1-13 weeks). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio positive, likelihood ratio negative, and overall accuracy were calculated using cut points 3 or greater and 2 or greater. During pregnancy, PHQ-2 greater than or equal to 3 revealed low sensitivity (38.4%-44.7%) but high specificity (97.8%-99.3%). In postpartum, it revealed moderate sensitivity (56.9%-70.6%), high specificity (95.8%-99.8%), and fair overall accuracy in pregnancy (70%). The alternative threshold greater than or equal to 2 revealed very high sensitivity (pregnancy: 92.1%-95.2%; postpartum: 87.1%-95.2%), moderate specificity (pregnancy: 78.1%-83.2%; postpartum: 68.8%-81.1%) and good overall accuracy, both during pregnancy (87%) and postpartum (84%). The PHQ-2 provided acceptable accuracy for screening for depression compared with the PHQ-9. In perinatal screening practice, a threshold of 2 or greater should be preferred as this ensures high sensitivity, missing only approximately 6% to 8% of cases, and a false-positive rate (percentage of women classified as affected with depressive symptoms when they are not) of 19% to 25%.