Screening for depression and anxiety disorders in primary care patients.

Mood and anxiety disorders are highly prevalent in primary health care. In this study we assessed performance of the Hospital Anxiety and Depression Scale (HADS) for screening of depression and anxiety disorders in a population of primary care patients. A total of 503 primary care patients consecutively admitted to the primary care medical center in Kaunas, Lithuania, completed the study. We found that the HADS subscale of depression (HADS-D) at a cutoff score of 6 or more showed the best performance screening for a major depressive episode diagnosed by means of the Mini International Neuropsychiatric Interview (MINI), with a sensitivity of 80%, specificity of 69%, positive predictive value of 80%, negative predictive value of 92%, and area under the receiver operating characteristic (ROC) curve of 0.75. Performance of the HADS-D against MINI diagnosis of dysthymia was weak. The HADS subscale of anxiety (HADS-A) at a cutoff score of 9 or more showed the best performance screening for MINI diagnosis of overall anxiety disorders, with a sensitivity of 77%, specificity of 75%, positive predictive value of 53%, negative predictive value of 90%, and area under the ROC curve of 0.76. These results suggest that in primary care patients HADS is an adequate screening instrument for the MINI diagnoses of major depressive episode, but not for dysthymia at a cutoff score of 6, and for anxiety disorders at a cutoff score of 9.

Bunevicius A ，Peceliuniene J ，Mickuviene N ，Valius L ，Bunevicius R ... -  《DEPRESSION AND ANXIETY》

Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale.

Sagen U ，Vik TG ，Moum T ，Mørland T ，Finset A ，Dammen T ... -  《-》

Psychiatric morbidity and its screening in Turkish women with breast cancer: a comparison between the HADS and SCID tests.

Adjustment disorders (ADs) and major depressive disorder (MDD) are often the most prevalent psychiatric disorders among cancer patients. This study's objective was to determine the overall performance of Hospital Anxiety and Depression Scale (HADS) as a screening instrument in identifying cases of psychiatric morbidity such as ADs and MDD. Two hundred and four consecutive patients completed a questionnaire including a demographic and clinical data form, HADS, and were examined with the Structured Clinical Interview for DSM-IV (SCID). The screening performance of HADS was investigated by calculating the area under the receiver operating characteristics curves (AUC), rates of specificity, and sensitivity. For MDD; the AUC was 0.77 on the HADS total, the AUC was 0.79 on the HADS depression subscale, and was 0.72 on the anxiety subscale. For ADs; the results were 0.74, 0.74, and 0.70 respectively. Findings indicated that a HADS total cut-off score of > or =17 to be optimal in identifying cases of MDD. This cut-off score offered a sensitivity of 0.70 and a specificity of 0.80. Findings suggested that a HADS total cut-off score of 10 was the optimal combination of sensitivity (0.84) and specificity (0.55) for ADs. When compared with SCID, the percentage of cases identified by HADS was 28% for MDD and 22% for ADs. Compared with SCID, HADS was found to have acceptable levels of sensitivity and specificity in detecting psychiatric morbidity especially for MDD and HADS can be recommended with reservations as a screening tool for breast cancer patients.

Ozalp E ，Soygür H ，Cankurtaran E ，Turhan L ，Akbiyik D ，Geyik P ... -  《-》

Cognitive and anxiety symptoms in screening for clinical depression in diabetes: a systematic examination of diagnostic performances of the HADS and BDI-SF.

Little systematic research into the diagnostic performance of instruments used to screen for clinical depression is available for people with diabetes. The objective of this study was to compare performances of the HADS and BDI-SF and their components in association with a standard diagnostic interview. In a sample of 298 French outpatients from a diabetes clinic (165 men, aged 59.4 + or - 10.7 years), we assessed diagnoses of clinical depression (CD, n=42) and major depression (MD, n=30) using the MINI and administered the HADS and BDI-SF. Cognitive symptoms from the BDI-SF (BDIcog) were more closely associated with MD than CD. BDIcog and HADS total scores performed best overall in identifying clinical depression (AUCs under ROC curve 85%). For identification of CD, the sensitivity/specificity of BDI cognitive symptoms was 88/71% (cutoff 3+) and for the HADS 83/65% (cutoff 13+). For identification of MD, BDIcog scored 83/80% (cutoff 4+) and HAD-A 80/76% (cutoff 9+). Logistic regression analyses further suggested that BDIcog and HAD-A discriminated between depressed and non-depressed patients better than the somatic and anhedonia items present in the same scales. The depression subscale of the HADS performed poorly. The consecutive nature of the sample may limit the generalizability of our findings. Results suggest that, in addition to depressed mood, both negative thoughts and anxiety are core elements for the correct identification of clinical depression in chronic illnesses such as diabetes. It may be more appropriate to use the total score when applying the HADS and distinguish non-somatic symptoms within the BDI.

Sultan S ，Luminet O ，Hartemann A 《-》

Relationships among pain, anxiety, and depression in primary care.

Means-Christensen AJ ，Roy-Byrne PP ，Sherbourne CD ，Craske MG ，Stein MB ... -  《-》