One question as a screening instrument for depression in people with multiple sclerosis.

OBJECTIVE: To evaluate how effectively one question 'Are you depressed?' works as a screening tool for depression in people with multiple sclerosis.
DESIGN: The results from a single question were compared with formal clinical diagnosis and the classification from a standard questionnaire.
SETTING: Estonian Multiple Sclerosis Centre, from October 2001 to April 2002.
SUBJECTS: One hundred and thirty-four consecutive inpatients with multiple sclerosis. INTERVENTION: During two weeks of inpatient stay the mood disorder was analysed. On the basis of clinical interview and Beck Depression Inventory the diagnosis of depression was confirmed. MAIN MEASURES: Beck Depression Inventory and structured clinical interview.
RESULTS: Fifty-seven per cent (77/134) of people with multiple sclerosis answered 'Yes' to the question 'Are you depressed?'. The diagnosis of depression was confirmed in 94% (72/77) of people with multiple sclerosis and not confirmed in 6% (5/77). Hence, the screening test sensitivity was 91%. Forty-three per cent (57/134) answered 'No'; 70% (40/57) did not have depression. In this case the sensitivity was 54%. In this group 30% (17/57) were actually depressed according to tests and clinical impression. The age, sex, duration of disease, cognitive abilities and physical disability did not influence consistency of the answers with test results and clinical opinion.
CONCLUSIONS: One-question interview is a useful tool for screening for depression in people with multiple sclerosis as it confirms existing depression (sensitivity 91%), but the results should be treated with caution if the person denies mood problems.