Screening Tool For Depression Research Articles

Establishing the content validity of an online depression screening tool for South Africa

Depression is a global concern as with an estimated 300 million individuals worldwide experiencing depression. In South Africa, the prevalence rate of depression is estimated at 9.7% of the population. With the increase in mobile internet usage in South Africa, an online depression screening tool could provide opportunities for the screening of depression symptoms aiding access to mental health interventions. This project identified an open access tool for screening depression, the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R), and adapted it for online use by the adult South African population. This study followed on from the adaptation phase on the CESD-R and aimed to determine the content validity of the adapted CESD-R for online use in South Africa using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. The study followed a two-phased design. Study one utilised a qualitative approach, where 50 experts commented on the content validity of the tool. The results were used to further adapt the tool which resulted in a 20-item depression screening tool. Study two followed a quantitative design in order to establish the content validity in terms of determining the Content Validity Ratios, Item-Content Validity Index as well as the Kappa Statistic of the 20 items. Based on these statistics, 19 of the 20 items were retained. Overall, the adapted online depression screening tool displays good content validity and holds potential as a screening tool where access to mental health may be limited.

Implementation of a Depression Screening Tool at the Department of Radiation Oncology

<h3>Purpose/Objective(s)</h3> Depression is a common comorbidity in cancer that has detrimental effects on patient health outcomes and quality of life. Unrecognized depression can impede treatment adherence resulting in disease progression and mortality in cancer patients. Inadequate depression screening and referral practices were observed and verbalized as a concern by internal stakeholders at an academic Radiation Oncology Department (ROD) in Baltimore, Maryland. Thus, the purpose of this Quality Improvement (QI) project was to implement and evaluate the Patient Health Questionnaire (PHQ-9) depression screening tool with subsequent psychosocial referrals for all positive screens. <h3>Materials/Methods</h3> The QI project used the Mobilize-Assess-Plan-Implement-Track (MAP-IT) framework. The QI team implemented four core interventions during the fifteen-week project: Staff education, PHQ-9 screening, provision of mental health resources, and psychosocial referrals for patients with moderate to severe depressive symptoms (PHQ-9 scores of ≥10). A convenience sample of adult cancer patients (≥18 years old) with a confirmed cancer diagnosis and a radiation treatment plan were eligible to participate. Rates of PHQ-9 screening, positive screens, referrals, and social worker follow-up were collected weekly, analyzed, and plotted on run charts. A combination of descriptive statistics, <b>t</b>-tests, and a chi-squared (X²) test examined differences between pre-and post-implementation data for statistical significance. <h3>Results</h3> All targeted staff attended the education session (n = 10), and there was a 100% completion rate for the pre- and post-surveys. Post education, the average score for staff competency significantly increased from 62% to 96% (<i>P</i> = < 0.001; 95% CI [17.5, 57.0]. Post-implementation, PHQ-9 screening compliance increased from 2% baseline to 67% (<i>P</i> = < 0.001, <b>df</b> = 1, n = 145). Of the patients screened, 19% scored above the threshold indicative of a positive screen (n = 27). Subsequently, all positive screens were referred to an Oncology Social Worker (<i>P</i> = < 0.001), and 93% received follow-up care (n = 25). <h3>Conclusion</h3> Routine depression screening and psychosocial referrals among cancer patients receiving radiotherapy in an outpatient setting are feasible when streamlined into the clinical workflow. An integrated care approach with PHQ-9 screening improves the early identification of depression and increases patient access to psycho-oncology care. Registered nurses are in critical positions to perform primary and secondary prevention interventions to reduce the burden of depression. Considerations for future development include a collaborative and stepped care approach to address the unmet psychosocial needs that exist in the oncology population.

Adverse childhood experiences and health risk behaviours by gender among Tunisian adolescents

Abstract Background Adverse Childhood Experiences (ACEs) have become an alarming phenomenon exposing individuals at a great risk of developing mental health issues. To date, there remains a lack of adequate researches on ACEs especially among adolescents. This survey aimed to describe the prevalence of childhood adversities and to determine their role in developing risky behaviours amongst Tunisian youth. Methods We conducted a cross sectional study among schooled adolescents in the governorate of Mahdia (Tunisia) from January to February 2020. Exposure to violence was assessed using the validated Arabic version of the WHO ACE questionnaire. The Internet Addiction Test (IAT) and the Hospital Anxiety and Depression scale (HAD) were used as a screening tool for internet addiction, anxiety and depression. Results A total of 1940 adolescents were recruited. The majority of them (97.5%) reported experiencing at least one ACE. Emotional neglect (83.2%) and witnessing community violence (73.5%) were the most reported ACE categories. According to gender, males had higher rates of exposure to physical abuse and social violence than females. The most common risky behaviour was internet addiction (50%) followed by substance use (16.6%). After adjustment for anxiety and depression, the dose-response association between ACE and risky behaviours was well established. Conclusions These results among youth have both public health and societal implications. Key messages The prevalence of exposure to adverse childhood experiences as well as risky behaviors are alarming among Tunisian adolescents. Screening addictive behaviors among youth with a history of childhood adversities is needed.

Pain drawing as a screening tool for anxiety, depression and reduced health-related quality of life in back pain patients: A cohort study.

Back pain patients are more likely to suffer from depression, anxiety and reduced quality of life. Pain drawing is a simple, frequently used anamnesis tool that facilitates communication between physicians and patients. This study analysed pain drawings to examine whether pain drawing is suitable as a screening tool for signs of anxiety, depression or reduced quality of life, as the detection of these symptoms is essential for successful treatment. Pain drawings of 219 patients with lower back pain were evaluated retrospectively. Pain drawings are a schematic drawing of a human being. Six variables of the pain drawing were analysed. Subscales of the Hospital Anxiety and Depression Scale (HADS) and the Mental Component Summary (MCS) of the Short Form 12 (SF-12) were used to measure anxiety, depression and quality of life, respectively. Descriptive statistics, uni- and multivariate linear regression analyses and analysis of variance were performed. Logistic regression analyses were conducted for suitable variables. We revealed significant positive correlations between the variables "filled body surface" and "number of pain sites" and the anxiety (HADS-A) and depression subscales (HADS-D) of the HADS (p<0.01). The same predictors had significant negative correlations with the MCS (p<0.01). However, the sensitivity and specificity of the variable "number of pain sites" were too low compared to those for existing screening tests to consider it as a screening tool for anxiety, depression and quality of life (HADS-A: sensitivity: 45.2%, specificity: 83.3%; HADS-D: sensitivity: 61.1%, specificity: 51%; MCS: sensitivity: 21.2%, specificity: 85.7%). There were significant correlations between the amount of filled body surface and the number of pain sites in the pain drawing and anxiety, depression and quality of life. Although useful in routine clinical practice, pain drawing cannot be used as a screening tool based on our results.

Edinburgh Postnatal Depression Scale used in South Korea

Background: The Edinburgh Postnatal Depression Scale (EPDS), a validated screening tool for prenatal and postnatal depression, was included as a reimbursable item by the National Health Insurance Service of Korea in 2020. However, multiple Korean versions of the EPDS are used for public health programs and research. This study aimed to summarize the use of this scale in Korea and evaluate the distribution of validities, depression scores, and prevalence of depression according to Korean versions of the EPDS.Methods: Korean versions of the EPDS most frequently used in public health policies and programs were summarized through internet searches using snowball strategy. A systematic literature review was conducted to evaluate the prenatal and postnatal depression scores and prevalence of depression measured using different Korean versions of the scale.Results: We identified four Korean versions of the EPDS that are commonly used in public health programs and research. Among them, published evidence regarding validity and reliability was available for two versions. A review of 19 papers that assessed prenatal and postnatal depression using these versions showed large heterogeneity in scores and the prevalence of depression.Conclusion: When measuring prenatal and postnatal depression using the EPDS, characteristics of the scale must be considered when interpreting results. A standardized Korean version of the EPDS needs to be developed by comparing the validity and reliability of different Korean versions. A field manual for screening should also be developed and distributed.

Depressive symptoms and socio-demographic correlates among adolescents in Kampala: a cross-sectional study

The aim of this study was to investigate the prevalence of depressive symptoms in secondary school students in Kampala, Uganda, and assess associations with demographic characteristics and living arrangements. In this cross-sectional study, 14- to 17-year-olds were recruited from six randomly selected schools in Kampala. Participants completed a questionnaire, covering demographic questions and the affective problems subscale of the Youth Self-Report (YSR) – a depression screening tool for minors. Scores range from 0 to 26; a minimum score of 9 and 8 for female and male participants, respectively, suggests depressive symptoms in the clinical range, according to standard (non-local) norms. Unadjusted logistic regressions were used to assess demographic (e.g., age, gender, religion, parental education) and family-related characteristics (e.g., living arrangements, household size) associated with symptoms of depression in the clinical range. In total, 503 participants were recruited, of which 26.6% had depressive symptoms in the clinical range (female: 32.5%, male: 18.1%; risk ratio [RR] = 1.79, 95% confidence interval [CI] [1.28, 2.51]). Those who reported living with only one parent (RR = 1.62, 95% CI [1.14, 2.30]) or another family member/friend (RR = 1.98, 95% CI [1.14, 2.30]) were at increased risk of depressive symptoms above clinical threshold compared with participants living with both parents. A quarter of urban low-risk school-going adolescents had depressive symptoms in the clinical range in Kampala; girls and adolescents not living with their parents were particularly vulnerable. It recommended that school staff be equipped with skills to identify students who may be at risk for depression and make appropriate referrals.

Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression: updated systematic review and individual participant data meta-analysis

ObjectiveTo update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting...

Perceived Facilitators of and Barriers to Implementation of a Decision Support Tool for Adolescent Depression and Suicidality Screening: Focus Group and Interview Study.

BackgroundScreening Wizard (SW) is a technology-based decision support tool aimed at guiding primary care providers (PCPs) to respond to depression and suicidality screens in adolescents. Separate screens assess adolescents’ and parents’ reports on mental health symptoms, treatment preferences, and potential treatment barriers. A detailed summary is provided to PCPs, also identifying adolescent-parent discrepancies. The goal of SW is to enhance decision-making to increase the utilization of evidence-based treatments.ObjectiveThis qualitative study aims to describe multi-stakeholder perspectives of adolescents, parents, and providers to understand the potential barriers to the implementation of SW.MethodsWe interviewed 11 parents and 11 adolescents and conducted two focus groups with 18 health care providers (PCPs, nurses, therapists, and staff) across 2 pediatric practices. Participants described previous experiences with screening for depression and were shown a mock-up of SW and asked for feedback. Interviews and focus groups were transcribed verbatim, and codebooks were inductively developed based on content. Transcripts were double coded, and disagreements were adjudicated to full agreement. Completed coding was used to produce thematic analyses of the interviews and focus groups.ResultsWe identified five main themes across the interviews and focus groups: parents, adolescents, and pediatric PCPs agree that depression screening should occur in pediatric primary care; there is concern that accurate self-disclosure does not always occur during depression screening; SW is viewed as a tool that could facilitate depression screening and that might encourage more honesty in screening responses; parents, adolescents, and providers do not want SW to replace mental health discussions with providers; and providers want to maintain autonomy in treatment decisions.ConclusionsWe identified that providers, parents, and adolescents are all concerned with current screening practices, mainly regarding inaccurate self-disclosure. They recognized value in SW as a computerized tool that may elicit more honest responses and identify adolescent-parent discrepancies. Surprisingly, providers did not want the SW report to include treatment recommendations, and all groups did not want the SW report to replace conversations with the PCP about depression. Although SW was originally developed as a treatment decision algorithm, this qualitative study has led us to remove this component, and instead, SW focuses on aspects identified as most useful by all groups. We hope that this initial qualitative work will improve the future implementation of SW.

Screening for Depression Among Recent Nigerian Graduates.

In recent times, Nigerian media have carried multiple reports of violent and traumatic social vices. These are well-known trigger factors for fear, worries, and anxiety for corp members and their families. Core member's presentations at the NYSC primary care clinic are commonly triggered by change in environmental, biological, and psychosocial factors which invariably affect their social and occupational functioning. The objective of the study was to screen for depression symptoms among young recent Nigerian graduates with the view of further evaluating those positive on screening test with subsequent diagnostic tests. The survey was conducted on 327 participants of the April 2017 batch of graduates during the Delta State National Youth Service Corps (NYSC) Orientation Camp period in Issele-Uku, Delta State, Nigeria. They were requested to complete a self-administered questionnaire comprising of 2 sections (i) Socio-demographic profile and (ii) Patient-Health Questionnaire -9 (PHQ-9) - a Depression screening tool. The prevalence of depression symptoms in the study was found to be 57.2%. Family size (P < 0.001) and sibling rank (P < 0.001) were the socio-demographic factors found to be related to depression. Independent predictors of depression were family size and sibling ranking. The study found the prevalence of depression symptoms among young adults to be 57.2% which is quite high. Family size and sibling rank were found to be independent risk factors.

MP52-20 THE IMPACT OF LOWER URINARY TRACT SYMPTOMS (LUTS) ON DEPRESSION AND DEPRESSIVE SYMPTOMS AMONG WOMEN 20-69 YEARS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II (MP52)1 Sep 2021MP52-20 THE IMPACT OF LOWER URINARY TRACT SYMPTOMS (LUTS) ON DEPRESSION AND DEPRESSIVE SYMPTOMS AMONG WOMEN 20-69 YEARS Stephanie Gleicher, Timothy Byler, and Natasha Ginzburg Stephanie GleicherStephanie Gleicher More articles by this author , Timothy BylerTimothy Byler More articles by this author , and Natasha GinzburgNatasha Ginzburg More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002082.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Studies have shown that women with LUTS have higher rates of depression, anxiety, and overall worse health perception. Correlations have been shown between symptom severity and worsened mental health status. The aim of this study was to compare the impact of varying urinary symptoms, such as SUI, UUI, and nocturia, on depression and depressive symptoms among women aged 20-69 years. METHODS: We queried NHANES between 2013-2018 for women aged 20-69 years. We defined SUI as “leakage during physical activity”, UUI as “leakage during non-physical activity” and nocturia as “≥ 2 voids/night”. Depression was defined by DSM criteria with cases reporting ≥5 symptoms from the patient health questionnaire (PHQ9) depression screening tool. We assessed various demographic and clinical variables such as age, race, education, insurance status, smoking status, hypertension (HTN), hyperlipidemia (HLD), body mass index (BMI), hemoglobin A1c (HbA1c), perceived heath status, and visits to mental health providers. We performed univariate analysis and multivariable logistic regression. RESULTS: Of the 6284 participants, 27% reported nocturia, 42% had SUI, and 9% had UUI. Depression was found in 5% of the cohort. Women with depression were significantly less educated, had less health insurance, more commonly smoked, had HTN and HLD, had higher BMI, and had higher HbA1c. Depressed women were twice as likely to have nocturia (51% vs 26%, p<0.001). 64% of depressed women had SUI and 21% had UUI (p<0.001). Depressed women were three times more likely to have negative health perception (36% vs 9%, p<0.001). Multivariate regression revealed increased risk of depression among women with SUI (OR 1.79, p=0.004) and nocturia (OR 1.65, p=0.007), but not UUI. While evaluating the impact of specific PHQ9 elements and SUI, multivariate analysis revealed significant correlations with “feeling tired” (OR 1.26) and suicidal ideation (OR 1.77). Nocturia and depression were significantly correlated with decreased interest (OR 1.39), poor sleep (OR 1.71), “feeling tired” (OR 1.26) and changes in appetite (OR 1.37). CONCLUSIONS: SUI and nocturia appear to be significantly associated with depression and depressive symptoms. These findings reinforce that LUTS cannot be considered an isolated symptom, but a factor impacting overall mental-health wellbeing. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e938-e938 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephanie Gleicher More articles by this author Timothy Byler More articles by this author Natasha Ginzburg More articles by this author Expand All Advertisement Loading ...

Color, Caption and Emoji – Using Instagram as a Screening Tool for Depression in Teenagers and Adults

Instagram, the largest growing social network site today, has grown exponentially since its launch in 2010. Mental health challenges, particularly anxiety and major depressive disorder in those aged 16 to 30 have been associated with Instagram’s popularity. Depression is of particular interest to health care providers within the public health sector: it affects 264 million people globally; suicide is the second most common cause of death in 18 to 29-year-olds. This age group also constitutes the main demographic group of Instagram users. A narrative review was conducted on peer-reviewed articles between January 2019-July 2020 to analyze Instagram use and its association with depression, and using it as a tool to diagnose depression. PubMed, EBSCO, NCBI, NIH, and Google Scholar were used to source articles published between 2015-2020. The narrative review focused on four primary papers. The first study looked at the social comparison theory, while the second and third studies used screening questionnaires in conjunction with analyzing an individual’s Instagram content into text-based scores. The fourth study analyzed the content of photos which were posted to give insight into an individual’s status regarding depressive states. Accounting for 18 to 30 year olds’ Instagram usage into how they engaged with content can accurately screen for, and diagnose depression.

Assessment of antenatal anxiety, depression and obsessive-compulsive disorder in pregnant women in the COVID-19 era.

To assess the mental health of pregnant women, with reference to anxiety, depression and obsessive-compulsive (OC) symptoms, during the COVID-19 pandemic. A cross-sectional survey was conducted in Ireland during the third wave of the pandemic between February and March 2021. Psychiatric, social and obstetric information was collected from pregnant women in a Dublin maternity hospital, alongside self-reported measures of mental health status. Of 392 women responding, 23.7% had anxiety, scoring >9 for GAD-7 (7-item generalised anxiety disorder), 20.4% had depression, scoring >9 for PHQ-9 (9-item depression screening tool: Patient health questionnaire) and 10.3% had obsessive-compulsive disorder (OCD), scoring >13 for Yale-Brown obsessive-compulsive scale symptom checklist (Y-BOCS). Amongst self-reported OCD symptoms, there was a preponderance for obsessions rather than compulsions. Of 392 women, 36.2% described their mental health as worse during the pandemic, most frequently describing symptoms of anxiety and sleep disturbance. When analysed against test scores, self-reported worsening of mental health was significantly associated with higher scores on the GAD-7, PHQ-9 and Y-BOCS scales. The three scores were positively interrelated. Poor mental health scores were associated with self-reported strain in relationship with the baby's father, and current or previous history of mental illness. This study found high levels of depression, anxiety and OC symptoms amongst pregnant women during COVID-19. This highlights the vulnerability of this group to mental illness and the importance of enhanced screening and support during pandemics.

Collaborative Care: Integrating Behavioral Health Into the Primary Care Setting.

Integrated behavioral health is a model of health care that aims to meet the complex health care needs of patients in primary care settings. Collaborative Care (CC) is an evidence-based model incorporating an interdisciplinary team to improve outcomes for behavioral health disorders commonly seen by primary care providers. CC was implemented in a nurse-managed health center in a medically underserved community of Chicago with a team of family nurse practitioners, psychiatric mental health nurse practitioners, and a licensed clinical social worker. Integration of the CC model required restructuring of the patient visit, the care team, and financial operations. Weekly team meetings were held for interdisciplinary case consultation and training for the primary care team by the psychiatric nurse practitioner. The model includes suggested goals of reducing patient scores of validated depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) screening tools to a score less than 5 points or to less than 50% of original score. During the initial year of implementation, 166 patients received care under the CC model, with 64 patients currently receiving active care. In this cohort, 22% reached suggested goals for depression and 47% for anxiety. CC has benefits for both patients and providers. Patients receive holistic treatment of both mental and physical health needs and access to psychiatric services for medication initiation and behavioral health modalities when necessary. We observed that the CC model improved collaboration with behavioral health specialists and the competence and confidence of family nurse practitioners.

Importance of Social Determinants in Screening for Depression

ImportanceThe most common screening tool for depression is the Patient Health Questionnaire-9 (PHQ-9). Despite extensive research on the clinical and behavioral implications of the PHQ-9, data are limited on the relationship between PHQ-9 scores and social determinants of health and disease.ObjectiveTo assess the relationship between the PHQ-9 at intake and other measurements intended to assess social determinants of health.Design, Setting, and ParticipantsCross-sectional analyses of 2502 participants from the Baseline Health Study (BHS), a prospective cohort of adults selected to represent major demographic groups in the US; participants underwent deep phenotyping on demographic, socioeconomic, clinical, laboratory, functional, and imaging findings.InterventionsNone.Main Outcomes and MeasuresCross-sectional measures of clinical and socioeconomic status (SES).ResultsIn addition to a host of clinical and biological factors, higher PHQ-9 scores were associated with female sex, younger participants, people of color, and Hispanic ethnicity. Multiple measures of low SES, including less education, being unmarried, not currently working, and lack of insurance, were also associated with higher PHQ-9 scores across the entire spectrum of PHQ-9 scores. A summative score of SES, which was the 6th most predictive factor, was associated with higher PHQ-9 score after adjusting for 150 clinical, lab testing, and symptomatic characteristics.Conclusions and RelevanceOur findings underscore that depression should be considered a comorbidity when social determinants of health are addressed, and both elements should be considered when designing appropriate interventions.

The Patient Health Questionnaire-9 (PHQ-9) as a brief screening tool for depression: a study of Iranian college students

ABSTRACT The aims of the present study were (a) to investigate the psychometric properties and to explore the factorial structure of the Patient Health Questionnaire-9 (PHQ-9), (b) to explore the association of PHQ-9 scores with Loneliness Scale (LS) scores, (c) to determine the severity of symptoms of depression, and (d) to examine sex differences. The PHQ-9 and LS were administered to a convenience sample of 260 Iranian university students. Cronbach's α was .84 for the PHQ-9. Two factors were extracted labelled “Affective", and “Somatic/Vegetative.” PHQ-9 scores correlated positively (r = .57) with LS scores. Suicidal ideation was predicted by both factors of the PHQ-9 and by their LS scores. Sixty-nine percent of the students experienced mild to severe depression, and the men and women did not differ significantly in scores. This study can provide data points for meta-analyses and may help to determine social, cultural or economic conditions influencing student depression.

Clarification the optimal cut-off values for Persian-language versions of depression screening tools in Iranian patients with type 2 diabetes.

Depression is the most common psychiatric disorder in patients with type 2 diabetes. There are many questionnaires to measure depression symptoms. These tools are generally used with the same cut-off points in different medical diseases. The present study investigates the optimal cut-off points of these tools in patients with type 2 diabetes in the Iranian diabetic population. The original version of this tool is prepared in Persian. Two-hundred and forty four patients with a diagnosis of diabetes were selected to participate in the study. The gold standard for diagnosing depression was the Structured Mini-International Neuropsychiatric Interview. We applied the cut-off points of the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Depression in Diabetes Self-Rating Scale (DDS-RS), Problematic Areas in Diabetes Survey (PAID), Hamilton Depression Rating Scale (HDRS) and Depression in Diabetes Self-Rating Scale (DDS-RS). 23.8% of patients were diagnosed with depression. Depressed patients had higher levels of HbA1c and physical complaints than non-depressed patients. In all tools, the sum of Sensitivity and Specificity of our proposed cut-off points was better than the conventional cut-off points. In HADS, the results showed that this questionnaire performed better and more efficiently than other tools. In patients with type 2 diabetes, it is better to use the proposed cut-off point's specific to this disorder in the Iranian population. These cut-off points have a higher ability to identify depressed and non-depressed cases.

27260 Depression screening for adolescent acne patients

Prior studies have associated acne vulgaris with increased risk for depression and suicidal ideation, suggesting a role for dermatologists in identifying at-risk patients. We therefore implemented a depression screening tool for all adolescent and young adult patients presenting to clinic with acne. To our knowledge, no publications have qualitatively described this process in the dermotologic setting. Our depression screening used the Patient Health Questionnaire-2 (PHQ-2), ideal for busy dermatology clinics given its brevity and sensitivity. Medical assistants administered the PHQ-2 on a tablet computer while rooming patients. All scores were reviewed by the dermatologist, and using an established algorithm proposed by McDonald et al, positive screens were further investigated and the appropriate provider(s) notified. Initial challenges in implementation included consistency of survey administration and communication between staff and clinicians. This was overcome with experience and developing streamlined, systematic processes. We found that depression screening could readily be incorporated into dermatology clinics without significant disruption to workflow or increased burden on the physician. In the future, we aim to administer the PHQ-2 within the electronic medical record to facilitate automatic documentation in patient charts. Although data collection was temporarily halted by the COVID-19 pandemic, preliminary results trend toward an inverse relationship between both oral acne treatment and isotretinoin, and positive PHQ-2 screen (adjusted OR = 0.18, 95% CI = 0.03-1.08, P = .06; adjusted OR = 0.11, 95% CI = 0.01-1.27, P = .08; respectively). While more data are required, this suggests an intriguing relationship between acne treatment and depression, and the potential utility of depression screening in this patient population.

Validation of the WHO-5 as a screening tool for depression among young adults in Malaysia

As depression has become a major disease burden in Malaysia, an easy-to-use tool with good psychometric qualities is urgently needed to facilitate the screening process. The current study aimed to investigate the psychometric qualities of the 5-item World Health Organization Well-being Index (WHO-5) and the optimal cut-off point for depression screening in the Malaysian context. A total of 610 undergraduate students answered an online survey consisting of the English version of the WHO-5 and Patient Health Questionnaire-9 (PHQ-9). Results of confirmatory factor analysis supported the single-factor model. The present study found the WHO-5 had a good reliability and concurrent validity. Moreover, receiver operating characteristic analysis indicated that ≤13 was the optimal threshold with acceptable sensitivity and specificity to detect depression. This study concludes the WHO-5 is a brief, valid, and reliable depression screening tool among young adults in Malaysia.

Development of the Anxiety, Depression and Coping (ADAF) screening tool for emotional and coping problems in cancer patients.

Clinical guidelines recommend psychological screening in cancer patients. However, most scales cover many items and hamper detection. In addition, patients are generally referred from routine consultations. The specific objective of the present study was to develop and validate a tool, Anxiety, Depression, Coping (ADAF), to screen for anxiety and depression and assess coping in cancer patients. Cross-sectional, multicenter study performed in the medical and radiotherapy-oncology services of five hospitals in Madrid and coordinated by the Medical Oncology Service of Hospital Clínico San Carlos (CEIC nº19/265-E). To determine psychometric properties, the ADAF screening questionnaire ADAF was administered. ADAF includes five items (1 related to anxiety symptoms, 2 related to depressive symptoms, 1 for helplessness coping, and 1 for avoidance coping). Hospital Anxiety and Depression Scale and Mini-Mental Adjustment to Cancer scale were used as the gold standards. Intraclass correlation coefficients were calculated and receiver operating characteristic (ROC) curves constructed. A p value of <0.05 was considered significant. A total of 186 patients completed the evaluation. The correlation coefficients were significant for all dimensions (anxiety, depression, helplessness coping, and avoidance coping) (p<0.001). The statistical analysis of the ROC curves suggested that the cut-off point for screening was >2 points (3 in the case of depression), with a sensitivity and specificity between 62% and 90%, and an area under the curve above 0.8 for the first 4 items. ADAF screening has adequate reliability and good sensitivity and specificity. This instrument is useful and can be easily applied to identify emotional and coping problems in cancer patients.

A systematic review of screening for perinatal depression and anxiety in community-based settings.

Screening for perinatal depression and anxiety in community-based maternal and child health settings may help close the detection and treatment gap among women at higher risk for these conditions. We aim to review perinatal depression and anxiety screening tools, timing, and follow-up processes for positive screens in community-based settings. We conducted a systematic review of the literature to identify papers describing screening and interventions for perinatal depression and anxiety in community-based settings. We identified 49 papers describing 47 studies of perinatal depression or anxiety screening in community-based settings. The Edinburgh Postnatal Depression Scale (EPDS) was the most frequently used screening tool. Referral and referral tracking for those who screened positive for symptoms were inadequately described. Types of training and technical assistance provided for screening varied widely. It is feasible and acceptable to screen for perinatal depression in community settings, but there is a need for systematic research examining which screening tools to use, the ideal frequency of screening, and referral completion rates. There is a lack of information regarding perinatal anxiety screening and a lack of uniformity in training regarding screening in community-based settings. Future studies should compare the efficacy of screening in community-based settings to screening in healthcare settings.