Self-rating Questionnaire For Depression Research Articles

The relationship between physical activity and depression in college students: the chain mediating role of mindfulness and meaning in life

AbstractIn order to explore the chain mediating effect of mindfulness and meaning in life between physical exercise and depression, 954 college students were investigated by physical exercise rating scale, self-rating depression questionnaire, mindfulness scale and meaning in life questionnaire. The results show that: (1) Physical exercise can significantly positively predict mindfulness and meaning in life, and significantly negatively predict depression; (2) The direct effect of physical exercise on depression of college students is not significant, but the indirect effect is significant. It can significantly predict depression of college students through the independent mediating effect of mindfulness and meaning in life, and can also significantly predict depression of college students through the chain mediating effect of mindfulness and meaning in life.

Implicit and Explicit Depression in Chinese Adolescents and Adults

Depression is a common mental problem worldwide. To identify the factor that contributes to depression in Chinese people, we measured the implicit association of depression in 25 people, using the BDI-13 self-rating depression questionnaire to measure their explicit depression. No correlation was found between implicit and explicit depression. Furthermore, participants gender will not influence the implicit depression score. Moreover, age was negatively correlated with an implicit depression score.

Positive airway pressure therapy for obstructive sleep apnea in patients with Osteogenesis imperfecta: a prospective pilot study

BackgroundObstructive sleep apnea (OSA) is prevalent in individuals with Osteogenesis imperfecta (OI). To date, no study has investigated treatment of OSA in adult individuals with OI using positive airway pressure (PAP). This observational pilot study examined the adherence of adults with OI to treatment of OSA with PAP therapy, and the evolution of self-experienced sleepiness and depression symptoms before and after treatment.MethodsWe included 20 patients, with a mean age of 51 years, who represented varying severity of OI and displayed an apnea and hypopnea index ≥ 5 /sleeping hour as recorded by an overnight polysomnography. PAP therapy was proposed to all patients. Epworth Sleepiness Scale (ESS) questionnaire to evaluate daytime sleepiness, and a validated self-rating depression questionnaire to identify possible depression, were completed prior to PAP therapy and repeated after a minimum of one year. The datasets supporting the conclusions of this article are included within the article.ResultsFrom the 20 patients, 15 initiated PAP therapy, and two patients later interrupted it. The mean PAP follow-up period was 1230 days. At baseline, an abnormally high ESS score was reported by 29% of the respondents, and an abnormally high number of symptoms suggesting depression by 29%. Follow-up questionnaires were completed by 60% of the patients, of whom 83% were adherent to PAP treatment. ESS score and depression symptoms did not decrease significantly with PAP therapy.ConclusionsPatients with OI accepted well PAP therapy and remained compliant. Sleepiness and depression persisted unaltered despite good PAP adherence. These unexpectedly poor improvements in symptoms by PAP therapy may be due to subjective depression symptoms and the complexity of factors underlying persisting sleepiness in OI. Further research is needed to confirm this novel finding.

Preoperative psychological factors affecting surgical satisfaction of elderly patients with lumbar spinal stenosis

ObjectiveThe objective of this observational study was to investigate the effects of preoperative psychological factors on short-term patient satisfaction with surgery in elderly patients with lumbar spinal stenosis (LSS). MethodsSurgery was performed on 90 elderly patients with clinically and radiologically defined LSS: mean age at surgery, 73 years; 46 men and 44 women. Patients completed questionnaires before surgery and 1 year postoperatively. They used a self-administered the Roland Morris Disability Questionnaire (RDQ), the Japanese Orthopaedic Association Back Pain Questionnaire (JOABPEQ), MOS 36-Item Short-Form Health Survey (SF-36), and satisfaction for surgery (VAS) were completed. At baseline, psychological factors were assessed using the Self-Rating Questionnaire for Depression (SRQ-D), Hospital Anxiety and Depression scale (HADS), Pain Catastrophizing Scale (PCS), Pain Anxiety Symptoms Scale-20, and Brief Scale for Psychiatric Problems in Orthopaedic Patients (BS-POP). At follow-up, patient satisfaction was evaluated using 2 items: (1) satisfaction with surgery and (2) Would you undergo the same surgery again?. ResultsSatisfaction item 1 correlated negatively with the VAS for low back pain, leg pain, numbness, JOABPEQ social life disturbance score, SF-36 physical function score, and HADS anxiety score (p < 0.05). Satisfaction 2 correlated negatively with age at surgery, VAS of leg pain, PCS magnification score, and BS-POP score (p < 0.05). Multiple regression analysis showed significant associations between satisfaction 1 and SF-36 physical function and HADS anxiety scores, and between satisfaction 2 and PCS magnification score (p < 0.05). Statistical analysisThe preoperative factors independently associated with surgical satisfaction were analyzed utilizing Speaman’s rank correlation coefficient and multiple regression analysis. ConclusionPhysical function and anxiety were identified as preoperative factors that affected patient satisfaction with surgery. Preoperative assessment of psychological factors and interventions for anxiety may help improve patient satisfaction after surgery for LSS.

Acylated ghrelin levels were associated with depressive status, physical quality of life, endoscopic findings based on Kyoto classification in Japan.

Background and Aims: To determine whether serum acylated ghrelin levels were associated with anxiety, clinical symptoms, depressive status, quality of life, gastric motility and endoscopic findings based on Kyoto classification in functional dyspepsia (FD) patients. Methods: We enrolled three groups, FD patients (n = 15) with high levels of acylated ghrelin, FD patients (n = 33) with normal levels of acylated ghrelin and FD patients (n = 35) with low levels of acylated ghrelin. There was no significant differences in the positivity of Helicobacter pylori infection among the three groups. Clinical symptoms were evaluated by Gastrointestinal Symptom Rating Scale (GSRS) and FD symptoms based on Rome III classification. Acylated ghrelin levels were measured by ELISA methods. Depressive status, anxiety, sleep disturbance were respectively asscessed by Self-rating questionnaire for depression (SRQ-D) score, STAI-state/-trait, Pittsburgh sleep quality index (PSQI) scores. Endoscopic findings were evaluated based on Kyoto classification. Results: Body Mass Index (BMI) in FD patients with low levels of acylated ghrelin was significantly higher (p<0.001 and p = 0.008, respectively) compared to those in FD patients with high and normal levels of acylated ghrelin. SRQ-D scores in FD patients with low levels of acylated ghrelin was significantly lower (p = 0.008 and p<0.001, respectively) compared to those in FD patients with high and normal levels of acylated ghrelin. Scoring of gastric atrophy, intestinal metaplasia, xanthoma and mucus based on Kyoto classification in FD patients with low levels of acylated ghrelin were significantly higher (p<0.001, p = 0.0077, p = 0.036 and p = 0.0063, respectively) compared to those in FD patients with more than low levels of acylated ghrelin. Conclusion: Acylated ghrelin levels were associated with BMI, depressive status, and endoscopic findings based on Kyoto classification in FD patients.

Comparison of clinical symptoms, gastric motility and fat intake in the early chronic pancreatitis patients with anti-acid therapy-resistant functional dyspepsia patients.

BackgroundThere was no available data concerning the clinical differentiation between the updated definition of early chronic pancreatitis (ECP) and anti-acid therapy-resistant functional dyspepsia (RFD).AimsWe aimed to determine whether clinical symptoms, gastric motility, psychogenic factors and fat intake can help distinguish early chronic pancreatitis (ECP) from anti-acid therapy-resistant functional dyspepsia patients with pancreatic enzyme abnormalities (RFD-P) and anti-acid therapy-resistant functional dyspepsia (RFD) patients using endosonography.MethodsWe enrolled 102 consecutive patients presenting with typical symptoms of RFD patients (n = 52), ECP patients (n = 25) and RFD-P patients (n = 25). ECP patients were diagnosed based on the criteria recommended by the Japan Pancreatic Association. Gastric motility was evaluated by 13C-acetate breath tests. Severity of duodenal inflammation was examined.Results24.5% of RFD patients were determined as ECP using endosonography. Abdominal pain score in Gastrointestinal Symptom Rating Scale (GSRS) in the patients with ECP was significantly lower compared to that in the patients with RFD-P. There were no significant differences in State-Trait Inventory (STAI)-state/-trait scores, Self-Rating Questionnaire for Depression (SRQ-D) scores and clinical symptoms for fat intake among three groups. The early phase of gastric emptying (AUC5; AUC15) in ECP and RFD-P patients were significantly disturbed compared to those in RFD patients.ConclusionsEvaluation of severity of abdominal pain and measurement of the early phase of gastric emptying will be useful tools to distinguish ECP patients from RFD patients. Accurate diagnosis of ECP patients may contribute to the prevention from advancing of chronic pancreatitis.

Factors Associated with Neck and Shoulder Pain in Volunteers.

Introduction The aims of the present study were 1) to examine the association between neck and shoulder pain (NSP) and lifestyle in the general population and 2) to examine if sagittal spino-pelvic malalignment is more prevalent in NSP. Methods A total of 107 volunteers (mean age, 64.5 years) were recruited in this study from listings of resident registrations in Kihoku region, Wakayama, Japan. Feeling pain or stiffness in the neck or shoulders was defined as an NSP. The items studied were: 1) the existence or lack of NSP and their severity (using VAS scale), 2) Short Form-36 (SF-36), 3) Self-Rating Questionnaire for Depression (SRQ-D), 4) Pain Catastrophizing Scale (PCS), 5) a detailed history consisting of 5 domains as being relevant to the psychosocial situation of patients with chronic pain, 6) A VAS of pain and numbness to the arm, and from thoracic region to legs. The radiographic parameters evaluated were also measured. Participants with a VAS score of 40 mm or higher and less were divided into 2 groups. Association of SF-36, SRQ-D, and PCS with NSP were assessed using multiple regression analysis. Results In terms of QoL, psychological assessment and a detailed history, bodily pain in SF-36, SRQ-D, and family stress were significantly associated with NSP. A VAS of pain and numbness to the arm, and from thoracic region to legs, was significantly associated with NSP. There were no statistical correlations between the VAS and radiographic parameters of the cervical spine. Among the whole spine sagittal measurements, multiple logistic regression analysis showed that sacral slope (SS) and sagittal vertical axis (SVA) were significantly associated with NSP. Conclusion In this study, we showed the factors associated with NSP. Large SS and reduced SVA were significantly associated with NSP, while cervical spine measurements were not.

AB020. Usefulness of RigiScan® evaluation of nocturnal penile tumescence

BackgroundThe RigiScan® is widely used for evaluating impairment of erectile function after traumatic events such as traffic accidents, workplace injuries, and surgical operations, and is often used in preparing diagnostic reports of erectile dysfunction, which can then be used as evidence in court cases. In Japan, the Ministry of Health, Labour and Welfare requires the use of RigiScan® monitoring for evaluating nocturnal penile tumescence (NPT) when assessing disability benefits for workplace accidents. We evaluated the accuracy of RigiScan® NPT testing for diagnosing erectile function.MethodsA total of 46 men (age range, 17–65 years) presented at our clinic from January 2007 through October 2016 to obtain an official erectile dysfunction diagnosis certificate after physical trauma, including traffic accident, workplace accident, fall resulting in spinal cord injury, surgery for repair of slipped disks, surgery to correct rectoceles, and damage to the urinary tract during insertion of urethral catheters. The reason for seeking a diagnosis certificate varied: patients wished to use them as proof of disability after a workplace accident, for insurance-benefit application forms, as evidence in court cases, and for assessment of postoperative sequelae. These diagnostic reports usually require six tests: (I) general blood testing, including serum hormone levels; (II) psychological testing including the Cornell Medical index and Self-Rating Questionnaire for Depression; (III) esthesiometry of phallic and perineal pallesthesia; (IV) neurological testing of anal sphincter tonus and anal and bulbocavernosus reflexes; (V) intracavernous injection of prostaglandin E1 (ICI PGE1) followed by RigiScan® evaluation of blood vessel response; and (VI) a 3-day RigiScan® evaluation of erectile function, to assess NPT while the patient is sleeping. Normal RigiScan® values are defined as: maximum erection hardness of 65% or greater, maximum penile circumference expansion to 3 cm or more at the base and 2 cm or more at the tip, and an erection time of 10 minutes or longer.ResultsOf the 20 patients evaluated with NPT only, 16 had normal NPT results (indicating normal erectile function) and 4 had NPT abnormalities (indicating vascular disorders and/or neuropathy). The remaining 26 men were evaluated with NPT and ICI testing: NPT and ICI were both normal in 10 (indicating normal erectile function), NPT was normal but ICI was not in 5 (classified as normal erectile function), ICI was normal but NPT was not in 4 (indicating neuropathy), and both NPT and ICI were abnormal in 7 men (indicating a vascular disorder, with or without neuropathy). How the outcomes of NPT and ICI testing were defined. Of the 26 men evaluated with both NPT and ICI testing, 5 had normal erectile function despite ICI abnormality, and another 4 had neuropathy despite normal ICI test findings. In the absence of NPT testing, diagnoses would have been based solely on ICI results, and 9 cases (35% of the 26 cases) would have been misdiagnosed. During ICI testing, response of smooth muscle in the corpus cavernosum to PGE1 is affected by psychological stress in the patient. Furthermore, ICI testing cannot be used to identify neuropathy.ConclusionsWhen evaluating erectile function, RigiScan® assessment of NPT is superior to use of PGE1 ICI alone.

Correlation between depressive state and post operative results in lumbar spinal canal stenosis patients with one-level fenestration procedure using Self-Rating Questionnaire for Depression (SRQ-D)

Correlation between depressive state and post operative results in lumbar spinal canal stenosis patients with one-level fenestration procedure using Self-Rating Questionnaire for Depression (SRQ-D)

Locomotive syndrome is associated with large blood pressure variability in elderly hypertensives: the Japan Ambulatory Blood Pressure Prospective (JAMP) substudy.

Chronic pain, represented by locomotive syndrome (LS), and psychosocial factors are possible factors of blood pressure (BP) variability (BPV). The authors tested the hypothesis that there are links among LS, depression, and BPV. In 85 Japanese elderly hypertensive patients with normal daily activities, the authors performed ambulatory BP monitoring, determined the LS scale (LSS), and administered the Self-Rating Questionnaire for Depression (SRQD). The LSS score but not the SRQD score was associated with the standard deviation (SD) and coefficient of variation (CV) of daytime systolic BP (SBP) and SD of nighttime SBP (all P<.05). Higher LSS score (in quartiles) was associated with a higher SD of daytime SBP (P=.041), even after adjusting for covariates. Regarding the components of the LSS score, movement-related difficulty and usual care difficulty were associated with the SD and CV of daytime SBP. In elderly hypertensive patients, the LSS score was associated with exaggerated systolic BPV. The LS state could be an important determinant of systolic BPV.

Correlation between depressive state and post operative results in patients with cervical laminoplasty using Self-Rating Questionnaire for Depression (SRQ-D)

Correlation between depressive state and post operative results in patients with cervical laminoplasty using Self-Rating Questionnaire for Depression (SRQ-D)

Depressive symptoms and spiritual wellbeing in Japanese university students

A scale was developed to broadly assess spirituality and to examine the association between depressive symptoms and spiritual attitudes of Japanese university students. In 2011, students in two universities (n = 527) participated in the study by completing the Self-Rating Questionnaire for Depression (SRQ-D), the 25-Item Sky Spirituality Scale (SS-25) and responding to questions on lifestyle and religiosity. The reliability and validity of the SS-25 were verified using the Cronbach's alpha coefficient and factor analysis. Results indicated that female students had higher total SS-25 scores. Moreover, there was a weak negative correlation between the SRQ-D and SS-25. The multiple linear regression model with gender and age as covariates also indicated that the life satisfaction domain was strongly associated with depression (beta = -0.418) and that the social connections domain was weakly associated with depression (beta = -0.147). Results of an analysis of covariance adjusted for gender and age indicated ...

Locomotive syndrome - an independent risk of large BP variability in elderly hypertensives. subanalysis from the Japan Ambulatory Blood Pressure Prospective (JAMP) study

Background: Blood pressure variability is a risk for target organ damage, cardiovascular-and non-cardiovascular prognosis. Acute pain and psychological factors rise BP, however it is unknown if locomotive syndrome (LS), a major cause of frail elderly, and depressive state are associated with large BP variability (BPV). We tested the hypothesis that locomotive syndrome (LS) or depressive state is associated with large BP variability in the elderly hypertensives. Methods: In 85 elderly hypertensive subjects in Ohshima island (mean age, 79.2 years old; female, 62.4%), we performed ambulatory BP monitoring, and checked the risk for LS using the LS scale, and depressive states by self-rating questionnaire for depression (SRQD). The measure of ambulatory BPV was expressed by standard deviation (SD). Results: The median values of LS scale and SRQD were 14 (positive:S;16/100 points) and 5 (positive:S;16/54 points), respectively. LS scale, but not SRQD, was significantly associated with SD in daytime SBP (p<0.05). When dividing subjects into the quartiles of LS scale, LS scale was positively associated with SD in daytime SBP (p1⁄40.038). SD in daytime SBP in the highest quartile group was significantly higher than that in the lowest quartile group. The relationship remained significant even after adjusting for age, sex, and BMI (Figure). Conclusion: Locomotive syndrome was independently associated with large BP variability in elderly hypertensives living in the remote island.

Correlation between depressive state and post operative results in lumbar disc herniation patients with MED procedure using Self-Rating Questionnaire for Depression (SRQ-D)

Correlation between depressive state and post operative results in lumbar disc herniation patients with MED procedure using Self-Rating Questionnaire for Depression (SRQ-D)

The association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients.

The causes of cancer-related fatigue, which can influence patients' activities, are multidimensional; however, little is known about the cognitive dimension. We examined the association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients after primary treatment. This descriptive, cross-sectional study recruited 20-64-year-old breast cancer patients in an outpatient setting. The patients (N = 93; mean age = 53 years) were divided into low (L-CogF) and high-cognitive fatigue (H-CogF) groups according to their scores on the cognitive fatigue subscale of the Cancer Fatigue Scale. We compared the groups on their sociodemographic and medical characteristics and scores on the Functional Assessment of Cancer Therapy-Breast (FACT-B) [a measure of quality of life (QOL)], Simplified Menopausal Index (SMI), and Self-Rating Questionnaire for Depression (SRQ-D). The L-CogF (n = 55) and H-CogF (n = 38) patients did not differ in age, years since diagnosis, marital status, educational background, or treatment history. Total and subscale FACT-B scores, except for physical well-being, were significantly lower in H-CogF participants than in L-CogF participants. SMI and SRQ-D scores were significantly higher in H-CogF participants. Employed H-CogF participants were concerned about keeping their jobs (p < 0.05). Breast cancer patients with high-cognitive fatigue suffer from severe menopause and depressive symptoms, and deteriorating QOL. Cognitive fatigue should be considered when interpreting patients' cognitive complaints.

Distinct Associations Between Depression Status and Initial Phase of Gastric Emptying in Functional Dyspepsia and Healthy Volunteers

Background/Aims: The association between initial phase of gastric emptying and clinical symptoms and depression status in functional dyspepsia has not been studied in detail. Methods: The subjects were 20 patients with Rome III-based functional dyspepsia and healthy volunteers. We evaluated upper abdominal symptoms using GDSS score and used Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Gastric motility was evaluated with the 13C-acetate breath test.

Plasma levels of leptin in reproductive‐aged women with mild depressive and anxious states

Recent studies suggest that leptin may have an effect on emotion and mood. Low levels of leptin in depression and anxiety have been reported in many animal models; however in humans, it has yet to be elucidated as to whether plasma leptin levels are low in similar states. Therefore, in this study we investigated how plasma leptin level and salivary stress markers of reproductive-aged women, who constitute the majority of patients with mild depression and anxiety in our clinic, are different from those of healthy women. We compared the results of the Medical Outcome Study 36-Item Short-Form Health Survey, the Self-rating Questionnaire for Depression, the State-Trait Anxiety Inventory, plasma leptin levels, and salivary stress markers in 29 depressive and anxious reproductive-aged female patients with those in 26 age- and body-mass-index-matched healthy female volunteers. The Short-Form 36, Self-rating Questionnaire for Depression and State-Trait Anxiety Inventory scores in the patients were worse and their leptin levels were lower than those in the healthy volunteers. There were no significant differences in salivary stress markers, such as chromogranin A and cortisol, between the patients and healthy volunteers. This study suggests that leptin might play a pathophysiological role in reproductive-aged female patients for mild depression and anxiety.

Impact of Coexisting Irritable Bowel Syndrome and Non-erosive Reflux Disease on Postprandial Abdominal Fullness and Sleep Disorders in Functional Dyspepsia

The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail. The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores. There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone. Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

Anhedonia in Japanese patients with Parkinson's disease

Anhedonia has been proposed as a specific mood disorder related to the dopaminergic nerve dysfunction seen in Parkinson's disease (PD). This study examined hedonic tone in patients with PD using the Snaith-Hamilton Pleasure Scale (SHAPS) and investigated the associations with depressive mood by the Self-Rating Questionnaire for Depression (SRQ-D). This study examined 100 patients with PD and 111 age-matched controls (C2) recruited from 300 healthy subjects (C1) to compare the frequency of anhedonia and to clarify whether anhedonia in PD is associated with depression and anti-Parkinson medication. Forty-six percent of PD patients revealed possible/probable depression and 10 patients (10%) with PD showed anhedonia as compared to 3.3% in C1 and 2.7% in C2. The reduction in hedonic tone was related to depression in PD. Among 10 PD patients with anhedonia, seven were in anhedonia with depression and three were in anhedonia without depression. There was no sex difference in anhedonia and depression. No patients treated with pramipexole showed anhedonia but also the highest proportion of normal hedonic tone was found in patients treated with pramipexole among PD patients. In analysis of each SHAPS item, no significant difference was seen on social interaction scores in contrast to the significant reduction of interest/pastimes and sensory experience and food/drink scores between PD patients and C1/C2. Anhedonia may overlap depressive syndrome but some PD patients without depression presented anhedonia. Pramipexole could maintain hedonic tone. The PD patients could enjoy attracting attention and wish to do things helpful for others.

The validity of the Depression Scale (DEPS) to assess the severity of depression in primary care patients

There is a need for a simple depression questionnaire also capable of assessing the severity of depression. The Depression Scale (DEPS), has been a very popular self-rating depression questionnaire in Finland for >15 years. Our aim was to examine whether the DEPS has the ability to differentiate clearly defined levels of depression in primary care patients. Primary care patients aged 18-64 years completed a postal questionnaire including the DEPS. All screen-positive subjects and every 10th screen-negative subject were invited for interview using the Present State Examination (PSE) as the gold standard. Complete DEPS score was available for 410 patients. Descriptive statistics of the DEPS in the six diagnostic PSE classes were computed. Four of the PSE classes were selected for further analyses of depression severity. Receiver Operating Characteristic curves, sensitivity, specificity, ideal cut-off points and area under the curve were calculated. The ability of the DEPS to differentiate levels of functioning was also evaluated. The DEPS identified three groups of patients: those with no psychiatric symptoms, those with some depressive symptoms and those with clinical depression. The margins between the levels were thin: the ideal cut-off point for clinical depression was 11/12 and for any level of depression 9/10. The DEPS was also able to differentiate three levels of functioning. The DEPS has some ability to identify severity of depression in primary care patients. Further research with larger unscreened material is called for.