Scott B Patten1, Jodie M Burton2, Kirsten M Fiest3, Samuel Wiebe2, Andrew G M Bulloch4, Marcus Koch2, Keith S Dobson5, Luanne M Metz2, Colleen J Maxwell6, Nathalie Jetté2. 1. Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada/Mathison Centre for Research & Education in Mental Health, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada patten@ucalgary.ca. 2. Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada/Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 3. Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 4. Mathison Centre for Research & Education in Mental Health, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada/Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. 5. Department of Psychology, University of Calgary, Calgary, Alberta, Canada. 6. School of Pharmacy, University of Waterloo, Ontario, Canada.
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.
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.
Authors: Julia M P Poritz; Joseph Mignogna; Aimee J Christie; Sally A Holmes; Herb Ames Journal: J Spinal Cord Med Date: 2017-03-29 Impact factor: 1.985
Authors: Kirsten M Fiest; John D Fisk; Scott B Patten; Helen Tremlett; Christina Wolfson; Sharon Warren; Kyla A McKay; Lindsay I Berrigan; Ruth Ann Marrie Journal: Int J MS Care Date: 2016 Mar-Apr
Authors: Sigurd Mikkelsen; David Coggon; Johan Hviid Andersen; Patricia Casey; Esben Meulengracht Flachs; Henrik Albert Kolstad; Ole Mors; Jens Peter Bonde Journal: Eur J Epidemiol Date: 2021-02-12 Impact factor: 8.082