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    17 views7 pages

    Harvard Department of Psychiatry National Depression Screeni PDF

    Uploaded by

    Lorena Teodora Cazacu

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    (HAWPes Regular Article Peychather Peychotom 2000;80:35 41 Development of a Brief Screening Instrument: The HANDS Lee Baer Douglas G. Jacobs Joelle Meszler-Reizes Mark Blais Maurizio Fava Ronald Kessler Kathryn Magruder Jane Murphy Barbara Kopans Peter Cukor Linda Leahy John O’Laughlen "Massachusens General HospitaEast, Charlestown, Mass, USA KeyWords Depression - Screening - Rating scales - Validity - Psychometrics sms from a variety of existing rating scales to 40 sub- jects who answered an ad for depressed subjects and 55 ‘who answered an ad for non-depressed subjects, all of ‘whose diagnoses were confirmed by the Structured Cli ical Interview for DSM-IV (SCID). Based on the correla- tion between each item and the diagnostic criterion, we reduced the number of items to 17 which we then admin- istered to another 45 subjects who answered an ad simi- lar to that used for NDSD and also underwent a SCID interview. Based on thes cd at the final 1 assistance of the item-response theo- ‘scores range 2005 Kane AG Bot (ans stoNoo 20817500 KARGER iit ‘Soe agers oma from 0 to 90. Results: The 10-item scale (HANDS) has {good internal consistency and validity jough specificity was lower for all scales in self-selected population, the HANDS performed at least as well as the 20-item Zung Scale, the 21-item Beck pression Inventory-II and the 16-item Hopkins Symp- ym Depression Checklist. Conclusion; The 10-item HANDS performs as well as other widely used longer self-report scales and has the advantage of briefer ad: ministration time. National Depression Screening Day (NDSD) was es- tablished in 1991 to (1) raise public awareness of depres- sion asan illness, (2)to make it knowa that effective treat- rents are available, (3) to help depressed individuals not being treated recognize that they are depressed and (4) to encourage them to seck help (1. 2]. An important element of NDSD js the administration of sereening questions designed to help people determine whether they meet cri ia for depression. Since 1995, the in-person screening on National Depression Screening Day has been supple- ‘ted by large-scale serecning which takes place over the telephone using digitized audio touch-tone technology anata Gee Hsia. Fame ug 8, Soe 2607 Mal terayh mph arte aaa sac eneemsanies i eee ‘As noted by Magruder et al. [1], since its inception, NDSD has used the 20-item se it has reliable screening tool and is seen by patients as non- threatening. However, concerns have been raise NDSD personnel and consultants that ¢ increasing volume of calls received at screening centers and also increase the precision of sereening.! There is good reason to believe that an effort to devel- op a brief yet precise screening scale could be successful. Indeed, evidence has accumulated that, if selected care. fully, shorter screening scales can perform as well as lon- ser scales for depression, For example, Whooley etal. [4] found that 1 question each regarding depressed mood and anhedonia were as good or superior to 6 common case- finding instruments used in a primary care setting. Simi- lariy, Schade et al. [5] recently reviewed the literature of depression screening and found that ‘several very brief instruments performed about as well as longer, well-vali- dated questionnaires for screening in primary care popu- lations. Furthermore, the optimal screening scale for NDSD ‘might be different from the optimal screening scale in a seneral population sample. As noted by Magruder et al. [1], the peaple who come to NDSD, and projects like it, are a selfselected group who already suspect that they ‘might be depressed. Thus, NDSD, ‘because of its volun- tary nature, is more akin to case finding, which results ina non-random, selfsclected study group that has unique clinical and sociodemographic characteristics’ [1]. As a ‘result, the kinds of sereening questions that might be best. in @ general population sample might not be as useful here. With this possibility in mind, we conducted two studies to develop and test the reliability and validity ofa 10-item screening scale for NDSD and for use in a more general audience, | Inde whiting the complstion ofthe ret uy. NDSI eel substituted fn the IVR ster only) 10-em sbuetof SDS eas alate by ‘egresion of individual items oa taal SDS scot in amass conduct ye ofthe sethors (KM) this temporary soation wat fund to erase thc put of cals hadley the IVR tem, ¥ Payee Paychosom 20009: viduals meeting najor depressive episode are considered to have a mood disorder, probably requiring treatment, rdless of whether the final diagnosis is majoc depres. sive disorder, bipolar depressive disorder or depressive disorder caused by organic factors. To assess the sensitive ty and specificity of our new brief scale, we compared scores on this scale to a gold standard clinical diagnostic interview, the Structured Clinical Interview for DSM-IV (SCID) [7], which has an established reliability [8} Method Subjects We conducted two studs of adults aged 18-75: In Study 1, we werited subject using wo dierent newspaper (Boston Globe) ads One ad recruited depressed patients, the other nandepressed pa tients, Those that answered the depressed ad and were found to Be ‘depressed by the SCID (n = 40) and those who answered the nonde pressed ad and were found not to be depressed by SCID (n= 53} were ‘accepted into the studs. These subjects, aftr giving informed con: sent, were given a packet of selreport depression rating quosticn. ‘naires to complete, Subjects were paid USD2S for pactiipaton in {his singlosession study, which required 1-3 to complete, In Stady 2, we attempted to simulate the seif-selected population that attends NDSD by placing several ad in the Boston Globe aco. ‘paper with wording similar to that in an ad run the previous yer to Advertise NDSD, We reerited 45 subjects. After providing writen informed consent, parents completed packet of rating. sales, "underwent the SCID interview and were paid USD2S far singe session requiring 1-3 hto complete In this population, we aden tered the rating scales without knowing whether or not any of these subjects were truly depressed by DSM-IV criteria. After the comple. tion ofthe questionnaires, weadminstered the SCID and found 29 of the subjects be depressed and 16 nondepresed, Many othe non- depressed subjects were found tohave other Axi I disorders Speci cally, 6 subjects were found to have one or mae cther Anis I disor ers: social phobia (n= 3), post-traumatic tess dieordec (PTSD) (a= 2), dg or leohol dependence (n = 2), body dysmorphic disorder (BOD) (a = 1), specific phobia (n = 1). adjustment disorder (n = 1),

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