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Piis1836955310700308 PDF
Piis1836955310700308 PDF
Commentary
Patients who present for physiotherapy care may also have obtained from large, relatively heterogenous samples. On
low or disturbed mood, particularly clinically relevant this basis, an individual severity rating reflects how far
symptoms of depression and anxiety. Co-morbid mood scores are positioned from these population means; the
disturbance is likely to influence patients’ symptoms further away the score is from the population mean, the
(including reporting of symptoms), complicate management, more severe the symptoms. If DASS scores suggest that a
and slow recovery from the primary presenting condition. patient has significant symptoms of depression, anxiety, or
Accurate evaluation of mood is therefore an essential stress, then referral to a qualified colleague with experience
element of a comprehensive physiotherapy assessment. The in managing mood disturbance is required.
application of a valid questionnaire is likely to assist with
evaluating mood disturbance and will reduce the likelihood For more information on the DASS the developers have
of the clinician failing to recognise these problems provided a comprehensive FA section on their web
(Haggman 2004). page, along with an overview and link to download the
questionnaire.
A variety of questionnaires assess mood disturbance but Luke Parkitny, James McAuley
many contain somatic items (eg sleep problems, loss of Neuroscience Research Australia (NeuRA), Randwick,
appetite), which are likely to reflect the patient’s presenting Australia
condition rather than any mood disturbance. The DASS
was developed with somatic items excluded to address References
this problem specifically. It is therefore likely to provide
Antony MM et al (1998) Psychol Assess 10: 176–181.
clinicians with an accurate assessment of their patient’s
symptoms of depression, anxiety and stress. Brown TA, et al (1997) Behav Res Ther 35: 79–89.
Clara I et al (2001) J Psychopathol Behav Asses 23: 61–67.
The DASS has excellent clinimetric properties and few
Crawford JR, Henry JD (2003) Brit J Clin Psych 42: 111–131.
limitations, however clinicians should be aware that
certain patient groups (eg children, the developmentally Haggman S et al (2004) Phys Ther 84: 1157–1166.
delayed, or those who are taking certain medications) may Lovibond PF, Lovibond SH (1995) Manual for the Depression
have difficulty understanding the questionnaire items or Anxiety Stress Scales 2nd ed. Sydney, Psychology
responding to them in an unbiased manner. For non-English Foundation.
speaking patients over 25 translations of the DASS are Ng F et al (2007) Acta Neuropsychiatr 19: 304–310.
available. Page AC, et al (2007) Brit J Clin Psych 46: 283–297.
Finally, we caution against using the DASS scores to Taylor et al (2005) Clin J Pain 21: 91–100.
independently diagnose discrete mood disorders such as Website
depression. The DASS is not intended to replace a complete mmm($fio$kdim$[Zk$Wk%]hekfi%ZWii
psychological assessment. It is important to remember that
DASS severity ratings are based on mean population scores