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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Internet may offer new opportunities for treating depressed adolescents. However, before such treatments are possible, well-validated screening instruments are needed. In the current study, we validate two Internet-based screening instruments for depression among adolescents, the major depression inventory (MDI), and the Center for Epidemiological Studies-Depression scale (CES-D). A total of 1,392 adolescents, recruited through high schools and the Internet, filled in the online questionnaires. Of these, 243 (17%) were interviewed with the MINI diagnostic interview to assess the presence of a mood disorder. Cronbach's alpha was high for both the CES-D (0.93) and the MDI (0.88), and both correlated highly with each other (0.88; P < .001). The scores on both instruments were significantly increased in all subjects with a mood disorder, whether current or lifetime, except for lifetime minor depression. In the ROC analyses, high areas under the curve were found for the MDI (0.89) and CES-D (0.90). The best cut-off point for the MDI was 19 (sensitivity: 90.48; specificity: 71.53), and for the CES-D it was 22 (sensitivity: 90.48; specificity: 74.31). We conclude that the MDI and CES-D are reliable and valid instruments that can be used for this screening.
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PMID:Screening of depression in adolescents through the Internet : sensitivity and specificity of two screening questionnaires. 1787 8

Withdrawal, apathy and lack of vigor (WAV) describe a pattern of lack of vitality and dropping of interests and activities in later life, which may or may not indicate depression. This study examines (a) whether the Geriatric Depression Scale (GDS) contains a measure of this symptom cluster, and if so, (b) whether the presence of WAV leads to more false positive predictions by the GDS. A total of 444 Chinese older persons responded to the GDS and the Mini-Mental State Examination (MMSE), and were independently assessed by psychiatrists for depression and other diagnoses. Confirmatory factor analysis showed that six WAV symptoms formed a distinct cluster on the GDS. WAV was positively correlated with age and MMSE but most other symptom clusters measured on the GDS were not. Nonetheless, the ROC curves were essentially the same, regardless of whether the WAV items were included or not. Further analysis revealed that the optimal cutoff for the GDS without WAV produced fewer false positives, but also missed more true cases, than the full scale. The extent to which false positives become an issue depends on the specific threshold chosen (which entails a tradeoff with sensitivity) rather than the presence of WAV items.
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PMID:Withdrawal, apathy and lack of vigor in late life depression: factorial validity and relationship to diagnosis. 1788 91

We examined differences in self-reported anxiety and depression according to the number and pattern of DSM-IV comorbid diagnoses in 172 children and adolescents (mean age=11.87, S.D.=2.67; range=7-17) with a primary diagnosis of social phobia. Three hypotheses were tested: (1) children with comorbid anxiety disorders would show significantly higher scores than children with social phobia-only on self-report measures, (2) self-report measures would significantly differentiate between children with social phobia and comorbid internalizing versus externalizing disorders, and (3) self-report measures would significantly differentiate children according to the type of anxiety comorbidities present. Multinomial logistic regressions showed that children with three anxiety disorders scored significantly higher than children with one and two diagnoses on two of three self-report measures used. Logistic regressions revealed that children's scores on measures did not differ according to the nature of the comorbid diagnoses (internalizing vs. externalizing). Finally, ROC curves showed that the MASC and the SPAI-C accurately classified children with additional diagnoses of SAD and GAD, respectively. The potential of self-report measures to further our understanding of childhood anxiety comorbidity and the clinical implications of their use to screen for comorbidity are discussed along with suggestions for further study.
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PMID:Self-report measures in the study of comorbidity in children and adolescents with social phobia: research and clinical utility. 1788 22

The objective of this study was to construct a patient- and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n=410), the Mini Mental State Examination (n=410) and a diagnostic interview (SCAN; n=333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, seven items that were identified as unsuitable were removed using the GDS-data of the Assess-project (n=77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specificity, area under ROC and positive and negative predictive values), the newly constructed 8-item version of the GDS was validated in the AGED data set (n=333), using DSM-IV diagnosis for depression as measured by the SCAN as 'gold standard'. In the AGED dataset, the GDS-8 was internally consistent (alpha=.80) and high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population.
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PMID:[The GDS-8; a short, client- and user-friendly shortened version of the Geriatric Depression Scale for nursing homes]. 1822 12

There is now evidence that major depression (MDD) is accompanied by an activation of the inflammatory response system (IRS) and that pro-inflammatory cytokines and lipopolysacharide (LPS) may induce depressive symptoms. The aim of the present study was to examine whether an increased gastrointestinal permeability with an increased translocation of LPS from gram negative bacteria may play a role in the pathophysiology of MDD. Toward this end, the present study examines the serum concentrations of IgM and IgA against LPS of the gram-negative enterobacteria, Hafnia Alvei, Pseudomonas Aeruginosa, Morganella Morganii, Pseudomonas Putida, Citrobacter Koseri, and Klebsielle Pneumoniae in MDD patients and normal controls. We found that the prevalences and median values for serum IgM and IgA against LPS of enterobacteria are significantly greater in patients with MDD than in normal volunteers. These differences are significant to the extent that a significant diagnostic performance is obtained, i.e. the area under the ROC curve is 90.1%. The symptom profiles of increased IgM and IgA levels are fatigue, autonomic and gastro-intestinal symptoms and a subjective feeling of infection. The results show that intestinal mucosal dysfunction characterized by an increased translocation of gram-negative bacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. It is suggested that the increased LPS translocation may mount an immune response and thus IRS activation in some patients with MDD and may induce specific "sickness behaviour" symptoms. It is suggested that patients with MDD should be checked for leaky gut by means of the IgM and IgA panel used in the present study and accordingly should be treated for leaky gut.
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PMID:The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. 1828 40

There are few studies about social anxiety disorder in Parkinson's disease (PD). The objective of this study was to assess its frequency and to explore the psychometric properties of the Liebowitz social anxiety scale (LSAS) in PD. Ninety patients with PD underwent neurologic and psychiatric examination. Psychiatric examination was composed by a structured clinical interview (MINI-Plus) followed by the application of the LSAS, the Hamilton depression rating scale (Ham-D), and the Hamilton anxiety rating scale (Ham-A). Neurologic examination included the MMSE, the UPDRS, the Hoehn-Yahr Scale, and the Schwab-England scale of activities of daily living. Social phobia was diagnosed in 50% of PD patients. The disorder was not associated with any sociodemographic or neurological feature, but was associated to major depression (P = 0.023), generalized anxiety disorder (P = 0.023), and obsessive-compulsive disorder (P = 0.013). The score of LSAS correlated positively with the scores of Ham-D and Ham-A (P < 0.001 for both). A ROC curve analysis of the LSAS suggested that a cutoff score in 41/42 provided the best balance between sensitivity and specificity. This disorder seems to be more common and not just restricted to performance as previously thought.
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PMID:Frequency of social phobia and psychometric properties of the Liebowitz social anxiety scale in Parkinson's disease. 1866 50

Psychological intervention after a large-scale disaster requires an efficient and practical measure. Using self-reporting scale imposes certain limitations, especially when dealing with the elderly. It is also required that non-experts in mental health should be able to use the screening device, so that it can be easily incorporated into any local level post-disaster health service. To satisfy such requirements, we developed a simple interview-format measure, the Screening Questionnaire for Disaster Mental Health (SQD), which screens for posttraumatic stress disorder (PTSD) and depression. In this article, its validity and usefulness was analyzed. Data were obtained from 68 individuals living in reconstruction housing five years after the 1995 Great Hanshin Earthquake. Applying the Clinician Administered PTSD Scale (CAPS) and the Structured Clinical Interview for DSM-III-R Major Depression Section (SCID) as gold standards, the areas under the Receiver Operating Characteristic curves (ROC-AUC) and stratum-specific likelihood ratios (SSLR) as statistical indices were calculated. The ROC-AUC was 0.91 (95%CI: 0.83-0.99) for diagnosing PTSD, and 0.94 (0.88-1.01) for diagnosing depression. Three strata for PTSD and 2 strata for depression were obtained, and SSLR for each stratum was 0.10 (95%CI: 0.02-0.45), 1.05 (0.37-3.00), 9.64 (3.77-24.69) for PTSD, and 0.3 (0.1-1.0), 7.8 (3.2-18.7) for depression. The results showed that this screening measure had good validity, especially for PTSD.
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PMID:A simple interview-format screening measure for disaster mental health: an instrument newly developed after the 1995 Great Hanshin Earthquake in Japan--the Screening Questionnaire for Disaster Mental Health (SQD). 1876 32

The Mental Health Inventory (MHI)-5 is an attractive, brief screening questionnaire for depression and anxiety disorders. It has been suggested that the three questions on depression (MHI-d) may be as good as the full MHI-5 in assessing depressive disorders. We examined the validity of the MHI-d and the MHI-a (the remaining two items on anxiety) in a large population-based sample of 7076 adults in the Netherlands. We also examined the validity of the MHI in assessing specific anxiety disorders. The presence of depressive and anxiety disorders in the past month was assessed with the Composite International Diagnostic Interview (CIDI), computerized version 1.1. ROC analyses indicated no significant difference between the MHI-5 (area under the curve of 0.93) and the MHI-d (area under the curve of 0.91) in detecting major depression and dysthymia. There was no difference either between the MHI-5 (area under the curve of 0.73) and the MHI-a (area under the curve 0.73) in detecting anxiety disorders. Both the MHI-5 and the MHI-a also seem to be adequate as a screener for some anxiety disorders (generalized anxiety disorder; panic disorder; obsessive-compulsive disorder), but not others, especially phobias (agoraphobia; social phobia; simple phobia).
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PMID:Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health Inventory. 1918 54

The aim of this study was to determine optimal cutoff scores for the Hospital Anxiety and Depression Scale (HADS) when used in evaluating cancer patients in acute care. A total of 689 cancer patients were assessed during their first days of in-patient treatment, using the structured clinical interview for DSM and the HADS. Statistical analysis was performed using ROC curves. A total of 222 patients (32%) had a mental disorder. The area under the curve was the best in the total scale of the HADS, namely 0.73. With a score of > or =13, it is possible to detect 76% of the cases with a specificity of .60, whereas 95% of the cases can be detected with a score of > or =6 (specificity 0.21). With scores of > or =16 and > or =22, recommended by the test authors for primary care, only 59 and 30% of the comorbid cancer patients are indicated. Lower HADS cutoff scores when preferable when evaluating cancer patients than are recommended for use in primary care. When using HADS in clinical practice and epidemiological studies, it is important to decide whether, for the task at hand, high detection rates of affected patients or low misclassification rates are more important.
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PMID:Hospital anxiety and depression scale cutoff scores for cancer patients in acute care. 1924 Jul 13

This study aimed to: (1) determine prevalence of depression in patients referred to specialist pain services using the Structured Clinical Interview (SCID) diagnostic interview, (2) compare results on the Beck Depression Inventory II (BDI-II) with the SCID to determine the utility of the BDI-II as a screening tool in this population. Thirty-six participants were recruited, mainly women, with a mean age = 47.83 years (standard deviation = 12.85 years), who were heterogeneous with regard to their pain. All completed the BDI-II and SCID. The SCID diagnosed 26 (72%) cases of depression. BDI-II scores showed 31 (86%) that reported at least mild depression. Agreement between BDI-II scores over threshold for mild depression and SCID diagnosis were assessed by Cohen's kappa (= 0.6). ROC analysis for BDI-II scores against SCID diagnosis gave a large area under the curve (0.97, 95% confidence interval 0.93 to 1.02), suggesting BDI-II is an excellent screen for this population, although the curve was unusual in that sensitivity was high even when the false positive rate was zero. ROC analysis suggested 22 or above as an optimum cut-off score for depression on the BDI-II-higher than for a general population sample. It has been suggested that the BDI overestimates incidence of depression in pain patients, but this study confirmed through diagnostic interview the very high incidence of depression in this population. It is therefore questionable whether there is value in screening referrals for depression. When using BDI-II for screening, audit or evaluation purposes with a pain clinic population, we suggest a cut-off of 22 or above.
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PMID:Depression in chronic pain patients: prevalence and measurement. 1929 63


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