Zwei-Fragen-Depressions-Screener – die Lösung aller Probleme?

Journal of Clinical Epidemiology, 2005

Objective: Test equivalence of different survey instruments to diagnose depression and to assess its severity. Where equivalence exists, describe how to convert scores between instruments. Study Design: Cross-sectional analysis of six convenience samples consisting of 71 members of a health plan and 107 patients of mental health specialty practices with psychiatric diagnoses were compared using the Beck Depression Inventory (BDI) and one or more of the Primary Care Screener for Affective Disorder, Prime-MD-PHQ, Inventory to Diagnose Depression, the depression subscale of the Psychiatric Diagnostic Screening Questionnaire, and the Mental Health Inventory from the SF-36. Results: Correlations between the screening instruments and the BDI ranged from 0.79 to 0.95 and the sensitivity to depression and the specificity against nondepressive mental health diagnoses was equally good or better. We also describe a method for equating severity scores across instruments and labeling the screener-based severity measures with clinically meaningful descriptions comparable to those used for the BDI. Conclusions: Screener-based severity measures extensively overlap each other. Good screeners for depression can also be good severity instruments. Exploiting screeners as severity instruments can significantly reduce response burden without sacrificing performance. Ć 2005 Elsevier Inc. All rights reserved.

Indian Journal of Medical Specialities, 2017

Globally, more than 350 million people of all ages suffer from depression. In spite of the high burden, depression is often unrecognized and undertreated. Inaccurate assessment is one of the important barriers for effective care. Clinical diagnosis is considered as the gold standard for the diagnosis of depression. However, the available instruments help to estimate the burden of depression in epidemiological studies as well as help to screen, diagnose and monitor the treatment in clinical practice. Screening instruments are very useful in community surveys, and can be used for referring patients to psychiatrists. Hence, there is a need to understand the different scales of depression, their advantages, limitations and psychometric properties. This article summarizes various available instruments for assessment of depression and their properties.

BMJ, 2003

Journal of …, 2010

Objective: The purpose of this study is to compare the diagnostic accuracy of four depression screening tools commonly used in patients with medical disorders, relative to a reference diagnostic standard-a structured psychiatric interview. Methods: The Depression in the Medically Ill-18 (DMI-18) questionnaire was administered to 167 patients with medical disorders; of those, 53 completed the Beck Depression Inventory for Primary Care (BDI-PC), 67 the Hospital Anxiety and Depression Scale (HADS), and 46 the Patient Health Questionnaire-9 (PHQ-9). The entire sample was also interviewed with a structured psychiatric interview conducted by a mental health professional. Sensitivity, specificity, likelihood ratios (LRs), and area under the curve (AUC) were calculated and compared for the different measures. Results: At their respective recommended cutoff points, sensitivities [95% confidence interval (CI)] were 86% (70-95), 82%

Medical Archives, 2014

Goal: The aims are to establish the prevalence of newfound, unidentified cases of depressive disorder by screening with the Becks Depression scale; To establish a comparative relationship with self-identified cases of depression in the patients in the family medicine; To assess the significance of the BDI in screening practice of family medicine. Patients and methods: A prospective study was conducted anonymously by Beck's Depression scale (Beck Depression Questionnaire org.-BDI) and specially created short questionnaire. The study included 250 randomly selected patients (20-60 years), users of services in family medicine in "Dom Zdravlja" Zenica, and the final number of respondents with included in the study was 126 (51 male, 75 female; response or response rate 50.4%). Exclusion factor was previously diagnosed and treated mental disorder. Participation was voluntary and respondents acknowledge the validity of completing the questionnaire. BDI consists of 21 items. Answers to questions about symptoms were ranked according to the Likert type scale responses from 0-4 (from irrelevant to very much). Respondents expressed themselves on personal perception of depression, whether are or not depressed. Results: Depression was observed in 48% of patients compared to 31% in self estimate depression analyzed the questionnaires. The negative trend in the misrecognition of depression is-17% (48:31). Depression was significantly more frequent in unemployed compared to employed respondents (p=0.001). The leading symptom in both sexes is the perception of lost hope (59% of cases). Conclusion: All respondents in family medicine care in Zenica showed a high percentage of newly detected (17%) patients with previously unrecognized depression. BDI is a really simple and effective screening tool for the detection and identification of persons with symptoms of depression.

Primary Care and Community Psychiatry, 2005

All rights reserved: reproduction in whole or part not permitted Background: A high number of patients in primary care suffer from depressive disorders. General practitioners (GPs) have an important function in detecting depression at an early stage. There is evidence that the detection of depressive disorders can be optimised by implementing routine screening. Aim: To analyse the acceptability of the PHQ-D as screening tool for depressive disorders in primary care. Design/Setting: Feasibility study in general practices in South Baden (Germany) Methods: 1034 patients of 17 GPs in single practices were screened with the Patient Health Questionnaire and asked to evaluate the screening tool in terms of its acceptability for routine practice. The GPs assessed the complaints and diagnoses of each patient and also evaluated the screening tool in terms of its practicability for daily care. Results: GPs and patients evaluate the screening questionnaire differently, with patients rating the usefulness of the instrument more positively. 50.0% of the GPs rated it as an impediment, whereas 75.8% of the patients evaluated it as feasible for routine. No differences were found between patients with and without depressive symptoms. Conclusion: Patients accept the PHQ-D for assessing depressive symptoms in primary care. The GPs' belief that patients would not accept such questionnaires proved not to be in accordance with the patients' evaluation. More detailed analyses are needed to evaluate the efficiency of the PHQ-D for routine care.

Journal of Affective Disorders, 2004

Background: The aim of this study was to compare the validity of the Hospital Anxiety and Depression Scale (HADS), the WHO (five) Well Being Index (WBI-5), the Patient Health Questionnaire (PHQ), and physicians' recognition of depressive disorders, and to recommend specific cut-off points for clinical decision making. Methods: A total of 501 outpatients completed each of the three depression screening questionnaires and received the Structured Clinical Interview for DSM-IV (SCID) as the criterion standard. In addition, treating physicians were asked to give their psychiatric diagnoses. Criterion validity and Receiver Operating Characteristics (ROC) were determined. Areas under the curves (AUCs) were compared statistically. Results: All depression scales showed excellent internal consistencies (Cronbach's a: 0.85 -0.90). For 'major depressive disorder', the operating characteristics of the PHQ were significantly superior to both the HADS and the WBI-5. For 'any depressive disorder', the PHQ showed again the best operating characteristics but the overall difference did not reach statistical significance at the 5% level. Cut-off points that can be recommended for the screening of 'major depressive disorder' had sensitivities of 98% (PHQ), 94% (WBI-5), and 85% (HADS). Corresponding specificities were 80% (PHQ), 78% (WBI-5), and 76% (HADS). In contrast, physicians' recognition of 'major depressive disorder' was poor (sensitivity, 40%; specificity, 87%). Limitations: Our sample may not be representative of medical outpatients, but sensitivity and specificity are independent of disorder prevalence. Conclusions: All three questionnaires performed well in depression screening, but significant differences in criterion validity existed. These results may be helpful in the selection of questionnaires and cut-off points. D

Journal of Psychiatric Practice, 2009

Background-Several studies have contrasted the 16-item self-report version of the Quick Inventory of Depressive Symptomatology (QIDS-SR 16) with other depression scales, but none has used patients in single, large, private psychiatric practice. This study compared 175 outpatients on the QIDS-SR 16 , the 17-item Carroll Depression Rating Scale (CDRS-SR 17 , a self-report modification of the Hamilton Rating Scale for Depression), and the thirteen depression items from the Symptom Check List-90 (SCL-D 13). The Mini version of the Structured Clinical Interview for DSM-IV (MiniSCID) served as a "gold standard" to assess depression. Methods-Basic Item and scale statistics were obtained using classical test theory. Dimensionalities were obtained using factor analysis. Test information functions obtained from the Samejima item response theory model provided additional reliability-like results. This model was also used to compare patients classified as depressed vs. nondepressed on the basis of the MiniSCID. Additional validity information was assessed comparing: (a) ANOVA effect sizes, (b) receiver operating characteristic curves, (c) univariate logistic regression, (d) the MANOVA, and (e) multivariate logistic regression. Results-The QIDS-SR 16 related most strongly to MiniSCID diagnoses. The SCL-D 13 , however, was the most reliable of the three scales (α = .91). It was the most sensitive to differences in depression for all but the most depressed patients, for whom the CDRS-SR 17 was the most sensitive. Conclusions-All three measures performed satisfactorily, but there are clearly defined advantages to using the QIDS-SR 16 , as, by its very design, it assesses the core symptoms of depression and does not require a clinician.

Nordic Journal of Psychiatry, 2010

Lotfi L, Flyckt L, Krakau I, M å rtensson B, Nilsson GH. Undetected depression in primary healthcare: Occurrence, severity and co-morbidity in a two-stage procedure of opportunistic screening. Nord J Psychiatry 2010;Early Online,1-7.

Psychiatry and Clinical Neurosciences, 1997