Diagnostic utility of a one-item question to screen for depressive disorders: results from the KORA F3 study

Background Screening for depressive disorders in the general adult population is recommended, however, it is unclear which instruments combine user friendliness and diagnostic utility. We evaluated the test performance of a yes/no single item screener for depressive disorders (“Have you felt depress...

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Vydané v:BMC family practice Ročník 14; číslo 1; s. 198
Hlavní autori: Blozik, Eva, Scherer, Martin, Lacruz, Maria E, Ladwig, Karl-Heinz
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London BioMed Central 23.12.2013
BioMed Central Ltd
Springer Nature B.V
Predmet:
Adult
Aged
Aged, 80 and over
Analysis
Depression - diagnosis
Depression - epidemiology
Depression, Mental
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - epidemiology
Epidemiology and research methodology in primary care
Family Medicine
Female
General Practice
Germany - epidemiology
Health surveys
Humans
Male
Mass Screening - instrumentation
Medical screening
Medicine
Medicine & Public Health
Methods
Middle Aged
Predictive Value of Tests
Primary Care Medicine
Primary Health Care - methods
Psychological research
Psychological tests
Psychometrics - instrumentation
Research Article
ROC Curve
Sensitivity and Specificity
Surveys and Questionnaires
Germany
Depressive Mood
Positive Predictive Value
Depressive Disorder
Negative Predictive Value
Major Depressive Disorder
ISSN:1471-2296, 1471-2296
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Shrnutí:Background Screening for depressive disorders in the general adult population is recommended, however, it is unclear which instruments combine user friendliness and diagnostic utility. We evaluated the test performance of a yes/no single item screener for depressive disorders (“Have you felt depressed or sad much of the time in the past year?”) in comparison to the depressive disorder module of the Patient Health Questionnaire (PHQ-9). Methods Data from 3184 participants of the population-based KORA F3 survey in Augsburg/ Germany were used to analyse sensitivity, specificity, ROC area, positive likelihood ratio (LR+), negative likelihood ratio (LR-), positive predictive value (PPV), and negative predictive value (NPV) of the single item screener in comparison with “depressive mood” and “major depressive disorder” defined according to PHQ-9 (both interviewer-administered versions). Results In comparison to PHQ-9 “depressive mood”, sensitivity was low (46%) with an excellent specificity (94%), (PPV 76%; NPV 82%; LR + 8.04; LR- .572, ROC area .702). When using the more conservative definition for “major depressive disorder”, sensitivity increased to 83% with a specificity of 88%. The PPV under the conservative definition was low (32%), but NPV was 99% (LR + 6.65; LR- .196; ROC area .852). Results varied across age groups and between males and females. Conclusions The single item screener is able to moderately decrease post-test probability of major depressive disorders and to identify populations that should undergo additional, more detailed evaluation for depression. It may have limited utility in combination with additional screening tests or for selection of at-risk populations, but cannot be recommended for routine use as a screening tool in clinical practice.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1471-2296
1471-2296
DOI:10.1186/1471-2296-14-198