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Abstract

Background:

There is a role for brief assessment instruments in detection and management of major depression in MS. However, candidate scales have rarely been validated against a validated diagnostic interview. In this study, we evaluated the performance of several candidate scales: Patient Health Questionnaire (PHQ)-9, PHQ-2, Center for Epidemiologic Studies Depression rating scale (CES-D), and Hospital Anxiety and Depression Scale (HADS-D) in relation to the Structured Clinical Interview for DSM-IV (SCID).

Methods:

The sample was an unselected series of 152 patients attending a multiple sclerosis (MS) clinic. Participants completed the scales during a clinic visit or returned them by mail. The SCID was administered by telephone within two weeks. The diagnosis of major depressive episode, according to the SCID, was used as a reference standard. Receiver-operator curves (ROC) were fitted and indices of measurement accuracy were calculated.

Results:

All of the scales performed well, each having an area under the ROC > 90%. For example, the PHQ-9 had 95% sensitivity and 88.3% specificity when scored with a cut-point of 11. This cut-point achieved a 56% positive predictive value for major depression.

Conclusions:

While all of the scales performed well in terms of their sensitivity and specificity, the availability of the PHQ-9 in the public domain and its brevity may enhance the feasibility of its use.

Keywords

Outcome measurement quality of life multiple sclerosis symptomatic treatment

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References

The Goldman Consensus Statement on Mood Disorders in Multiple Sclerosis. Mult Scler 2005; 11: 328–337.

Mohr

Hart

Tasch

. Screening for depression among patients with multiple sclerosis: Two questions may be enough. Mult Scler 2007; 13: 215–219.

Honarmand

Feinstein

. Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Mult Scler 2009; 15: 1518–1524.

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Washington: American Psychiatric Association, 2000.

Kroenke

Spitzer

Williams

. The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: A systematic review. Gen Hosp Psychiatry 2010; 32: 345–359.

Löwe

Kroenke

Herzog

. Measuring depression outcome with a brief self-report instrument: Sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord 2004; 81: 61–66.

Kroenke

Spitzer

Williams

JBW

. The PHQ-9. Validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–613.

Kroenke

Spitzer

. The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatr Ann 2002; 32: 1–7.

Arroll

Khin

Kerse

. Screening for depression in primary care with two verbally asked questions: Cross sectional study. BMJ 2003; 327: 1144–1146.

10.

Whooley

Avins

Miranda

. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997; 12: 439–445.

11.

Snaith

Zigmond

. The hospital anxiety and depression scale. Br Med J (Clin Res Ed) 1986; 292: 344.

12.

Zigmond

Snaith

. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.

13.

Feinstein

. The neuropsychiatry of multiple sclerosis. Can J Psychiatry 2004; 49: 157–63.

14.

Schiffer

. Depression in neurological practice: diagnosis, treatment, implications. Semin Neurol 2009; 29: 220–233.

15.

Radloff

. The CES-D scale: A self-report depression scale for research in the general population. Appl Psych Meas 1977; 1: 385–401.

16.

Weissman

Sholomskas

Pottenger

. Assessing depressive symptoms in five psychiatric populations: A validation study. Am J Epidemiol 1977; 106: 203–214.

17.

Beck

Ward

Mendelson

. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 53–63.

18.

Minden

Feinstein

Kalb

. Evidence-based guideline: Assessment and management of psychiatric disorders in individuals with MS: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2014; 82: 174–181.

19.

Strober

Arnett

. Assessment of depression in multiple sclerosis: Development of a ‘trunk and branch’ model. Clin Neuropsychol 2010; 24: 1146–1166.

20.

Benedict

Fishman

McClellan

. Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Mult Scler 2003; 9: 393–396.

21.

Chang

C-H

Nyenhuis

Cella

. Psychometric evaluation of the Chicago Multiscale Depression Inventory in multiple sclerosis patients. Mult Scler 2003; 9: 160–170.

22.

Bossuyt

Reitsma

Bruns

. The STARD statement for reporting studies of diagnostic accuracy: Explanation and elaboration. Ann Intern Med 2003; 138: W1–12.

23.

First

Spitzer

Gibbon

. Structured clinical interview for DSM-IV Axis I disorders. Research version, non-patient edition (SCID-I/NP). New York: New York State Psychiatric Institute, 1997.

24.

Simon

Revicki

VonKorff

. Telephone assessment of depression severity. J Psychiatr Res 1993; 27: 247–252.

25.

Cacciola

Alterman

Rutherford

. Comparability of telephone and In-person structured clinical interview for DSM-III-R (SCID) diagnoses. Assessment 1999; 6: 235–242.

26.

Rohde

Lewinsohn

Seeley

. Comparability of telephone and face-to-face interviews in assessing axis I and II disorders. Am J Psychiatry 1997; 154: 1593–1598.

27.

Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Publishing, 2013.

28.

Kurtzke

. Rating neurologic impairment in multiple sclerosis: An expanded disability scale (EDSS). Neurology 1983; 33: 1444–1452.

29.

Kroenke

Spitzer

Williams

. The Patient Health Questionnaire-2: Validity of a two-item depression screener. Med Care 2003; 41: 1284–1292.

30.

Bjelland

Dahl

Haug

. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002; 52: 69–77.

31.

Stata (version 12.1). College Station, TX: Stata Corporation, 2012.

32.

Haringsma

Engels

Beekman

. The criterion validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a sample of self-referred elders with depressive symptomatology. Int J Geriatr Psychiatry 2004; 19: 558–563.

33.

Julian

Gregorich

Tonner

. Using the Center for Epidemiologic Studies Depression Scale to screen for depression in systemic lupus erythematosus. Arthritis Care Res (Hoboken) 2011; 63: 884–890.

34.

Feinstein

. Depression associated with multiple sclerosis – looking beyond diagnosis to symptom expression. J Affect Disord 2001; 66: 193–198.

35.

Minden

Orav

Reich

. Depression in multiple sclerosis. Gen Hosp Psychiatry 1987; 9: 426–434.

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Validity of four screening scales for major depression in MS

Abstract

Background:

Methods:

Results:

Conclusions:

Keywords

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References

Supplementary Material