Depression screening in a women's clinic: using automated Spanish- and English-language voice recognition.

Clinical depression is frequently unrecognized, even in health care settings. This study (a) reports high levels of major depressive episodes (MDEs) and depressive symptoms in a public sector women's clinic, (b) compares computerized voice recognition with live interviews, and (c) compares Spanish and English versions of the depression-screening instruments. Patients (N = 104) completed face-to-face interviews and/or computerized voice recognition interviews in counterbalanced order; 38% scored positive for current MDE, and 67% scored positive for lifetime MDE. The mean score on the Center for Epidemiological Studies Depression scale (CES-D) was 22.1 (SD = 12.1), with 68% scoring 16 or above. No differences were found on either measure between English and Spanish speakers. Overall agreement between computer and live interviews was as follows: kappa = .82 for both current and lifetime MDE and r = .89 for CES-D scores. Kappas between the MDE Screener developed for this study and the Primary Care Evaluation of Mental Disorders were .75 for live interviews and .81 for the computerized version. Depression screening with computerized voice recognition methods yielded results comparable with those of live interviews in both English and Spanish.