The utility of brief instruments for depression screening in dialysis patients

Background Depression is a frequent but often underdiagnosed comorbid disorder in dialysis patients. The Beck Depression Inventory–Second Edition (BDI-II) is a reliable and valid instrument for depression screening but is relatively long for repeated use in clinical practice. The aim of this study w...

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Detalles Bibliográficos
Autores: Vázquez Rodríguez, María Isabel, Figueiras Guzmán, Adolfo, Salgado Barreira, Ángel
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad de Santiago de Compostela (USC)
Repositorio:Minerva. Repositorio Institucional de la Universidad de Santiago de Compostela
Idioma:inglés
OAI Identifier:oai:minerva.usc.gal:10347/38890
Acceso en línea:https://hdl.handle.net/10347/38890
Access Level:acceso abierto
Palabra clave:Beck Depression Inventory
Depression
Dialysis
Hospital anxiety and depression scale
SF-36
Descripción
Sumario:Background Depression is a frequent but often underdiagnosed comorbid disorder in dialysis patients. The Beck Depression Inventory–Second Edition (BDI-II) is a reliable and valid instrument for depression screening but is relatively long for repeated use in clinical practice. The aim of this study was to compare the BDI-II with the shorter questionnaires Beck Depression Inventory–FastScreen (BDI-FS), the depression subscale of the Hospital Anxiety Depression Scale (HADS-D), the Mental Health (MH) scale of the 36-item Short Form Health Survey (SF-36) and two items of the MH (‘So down in the dumps that nothing could cheer you up’ and ‘Downhearted and blue’) to determine the most efficient instruments for screening depressive symptoms in dialysis patients. Methods A cross-sectional study was conducted involving patients from 14 health centres undergoing in-centre haemodialysis or peritoneal dialysis. All patients completed the BDI-II, HADS-D and MH scale. The sensitivity, specificity and positive and negative predictive values for each brief instrument were assessed relative to BDI-II ≥16. Results Of the 145 patients included in the study (mean age 62 years; 66% male), 24.8% had depressive symptoms (BDI ≥16). The cut-off points with the highest sensitivity and negative predictive value for BDI-FS were ≥3 (91.7% and 96.1%, respectively) and ≥4 (80.6% and 92.4%, respectively) and for the HADS-D these were ≥4 (91.7% and 95.8%, respectively) and ≥5 (83.3% and 92.6%, respectively). The cut-off points for the total MH and the two items (considered separately or together) resulted in lower sensitivity (<80%) and lower negative predictive values (<90%). Conclusions Both the BDI-FS and HADS-D are adequate screening tools for depression in the dialysis population. As the BDI-FS is easier to complete and score and enables identification of patients at risk of suicide, it may be the best alternative to the BDI-II for depression screening in dialysis patients in clinical settings