Screening for depression in a musculoskeletal outpatient physical therapy clinic: Point prevalence and comparison of two instruments

Abstract

Background:

Depression is associated with risk of poor outcome in patients with musculoskeletal disorders, and is under-diagnosed in healthcare professional practice. The purpose of this study was to estimate the point prevalence of depression in a cohort of patients with musculoskeletal disorders attending an outpatient physical therapy clinic, and assess the efficiency and compliance with use of two versions of a patient-rated screening questionnaire.

Methods:

A cohort of all patients participating in an episode of physical therapy care during a four week time-frame completed the modified Zung Self-rated Depression Scale (mZSDS) questionnaire. Scores were calculated for both the original Zung Self-rated Depression Scale and the mZSDS.

Results:

The prevalence of depression was estimated to be 19.6% (95%CI 10.7, 33.3) in this population of patients attending an outpatient physical therapy clinic. Mean score on the mZSDS was out 23.6 out of 80 (sd 11.5). Compliance with completion of the mZSDS was 96%.

Conclusions:

The high prevalence of depression in patients with musculoskeletal disorders suggests that consideration should be given to screening in physical therapy practice. This pilot study indicates that use of the mZSDS as a screening tool is efficient and does not present major barriers to use. As depression is associated with increased risk of poor outcome, we recommend screening for depression in musculoskeletal outpatient physical therapy clinics.