Format

Send to

Choose Destination
Mult Scler. 2015 Jul;21(8):1064-71. doi: 10.1177/1352458514559297. Epub 2015 Jan 12.

Validity of four screening scales for major depression in MS.

Author information

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.

KEYWORDS:

Outcome measurement; multiple sclerosis; quality of life; symptomatic treatment

PMID:
25583846
DOI:
10.1177/1352458514559297
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center