Seon-Cheol Park1, Søren Dinesen Østergaard2, Joonho Choi3, Jae-Min Kim4, Tae-Youn Jun5, Min-Soo Lee6, Jung-Bum Kim7, Hyeon-Woo Yim8, Yong Chon Park9. 1. Department of Psychiatry, Yong-In Mental Hospital, Yongin, Republic of Korea; Institute of Mental Health, Hanyang University, Seoul, Republic of Korea. Electronic address: cogito-ergo-sum@hanmail.net. 2. Research Department P, Aarhus University Hospital, Risskov, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPsych), Denmark. Electronic address: SOEOES@rm.dk. 3. Institute of Mental Health, Hanyang University, Seoul, Republic of Korea; Department of Psychiatry, Hanyang University, Guri Hospital, Guri, Republic of Korea. Electronic address: jchoi@hanyang.ac.kr. 4. Department of Psychiatry, Chonnam National University School of Medicine, Gwangju, Republic of Korea. Electronic address: jmkim@chonnam.ac.kr. 5. Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, Republic of Korea. Electronic address: tyjun@catholic.ac.kr. 6. Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: leeminso@korea.ac.kr. 7. Department of Psychiatry, Keimyung University School of Medicine, Daegu, Republic of Korea. Electronic address: kim1159@dsmc.or.kr. 8. Department of Preventive Medicine, Catholic University of Korea College of Medicine, Seoul, Republic of Korea. Electronic address: y1693@catholic.ac.kr. 9. Institute of Mental Health, Hanyang University, Seoul, Republic of Korea; Department of Psychiatry, Hanyang University, Guri Hospital, Guri, Republic of Korea. Electronic address: hypyc@hanyang.ac.kr.
Abstract
BACKGROUND: The detection of psychotic depression (PD) among patients with depressive disorders is important for both treatment and monitoring. Therefore, in continuation of our previous work, this study aimed to test the ability of the five-item Brief Psychiatric Rating Scale (BPRS-5) of the Psychotic Depression Assessment Scale (PDAS) in separating patients with psychotic depression from those with non-psychotic depression (non-PD) and to compare this discriminative validity to that of other item sets. METHODS: A receiver operating characteristics curve was used to identify the optimal cut-off score of the BPRS-5 subscale for sensitive and specific distinction between PD and non-PD in a sample of 494 patients with depressive disorders (53 with PD and 441 with non-PD). RESULTS: Using an optimal cut-off score of 1, the sensitivity and the specificity of the BPRS-5 subscale in detecting PD were 71.2% and 87.2%, respectively. The BPRS-5 outperformed other item sets of the PDAS and the positive symptom subscale of the BPRS in identifying patients with PD. LIMITATIONS: The inter-rater reliability of the PDAS and the BPRS-5 subscale was not evaluated in this study. CONCLUSIONS: The BPRS-5 subscale can be regarded as a more sensitive screening method for PD compared to other item sets from the PDAS and the BPRS. Hence, from a screening perspective, a positive score on any of the five symptoms of the BPRS-5 subscale (hallucinatory behavior, unusual thought content, suspiciousness, blunted affect, and emotional withdrawal) is indicative of PD, and should lead to more thorough diagnostic assessment.
BACKGROUND: The detection of psychotic depression (PD) among patients with depressive disorders is important for both treatment and monitoring. Therefore, in continuation of our previous work, this study aimed to test the ability of the five-item Brief Psychiatric Rating Scale (BPRS-5) of the Psychotic Depression Assessment Scale (PDAS) in separating patients with psychotic depression from those with non-psychotic depression (non-PD) and to compare this discriminative validity to that of other item sets. METHODS: A receiver operating characteristics curve was used to identify the optimal cut-off score of the BPRS-5 subscale for sensitive and specific distinction between PD and non-PD in a sample of 494 patients with depressive disorders (53 with PD and 441 with non-PD). RESULTS: Using an optimal cut-off score of 1, the sensitivity and the specificity of the BPRS-5 subscale in detecting PD were 71.2% and 87.2%, respectively. The BPRS-5 outperformed other item sets of the PDAS and the positive symptom subscale of the BPRS in identifying patients with PD. LIMITATIONS: The inter-rater reliability of the PDAS and the BPRS-5 subscale was not evaluated in this study. CONCLUSIONS: The BPRS-5 subscale can be regarded as a more sensitive screening method for PD compared to other item sets from the PDAS and the BPRS. Hence, from a screening perspective, a positive score on any of the five symptoms of the BPRS-5 subscale (hallucinatory behavior, unusual thought content, suspiciousness, blunted affect, and emotional withdrawal) is indicative of PD, and should lead to more thorough diagnostic assessment.
Authors: S D Østergaard; A J Rothschild; A J Flint; B H Mulsant; E M Whyte; A K Leadholm; P Bech; B S Meyers Journal: Acta Psychiatr Scand Date: 2015-05-27 Impact factor: 6.392
Authors: Søren D Østergaard; Anthony J Rothschild; Alastair J Flint; Benoit H Mulsant; Ellen M Whyte; Tom Vermeulen; Per Bech; Barnett S Meyers Journal: J Affect Disord Date: 2015-10-22 Impact factor: 4.839