Validity and screening properties of three depression rating scales in a prospective sample of patients with severe traumatic brain injury

Abstract

Objective: To evaluate the validity and utility of the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS) as screening tools for depression after severe traumatic brain injury (TBI). Methods: Forty-six consecutive survivors of severe TBI were evaluated at a median of 15 months after injury. Receiver operating characteristic (ROC) analysis was performed using HAM-D, BDI, and HADS as predictors, and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) as gold standard. Results: The area under the curve (AUC) for HAM-D was 0.89, and the optimal cutoff point was 7 (sensitivity 92.9%, specificity 78.1%); for the BDI, the AUC was 0.946 and the optimal cutoff point was 14 (sensitivity 92.3%, specificity 96.7%); for the HADS, the AUC was 0.947 and the optimal cutoff point was 9 (sensitivity 100%, specificity 80.7%); and for the HADS depression subscale, the AUC was 0.937 and the optimal cutoff point was 6 (sensitivity 92.9%, specificity 83.9%). There were no statistically significant differences among the AUCs. Conclusion: Our findings support a high validity and utility for the HAM-D, BDI, and HADS as screening tools for depression in patients with severe TBI, without major changes in standard cutoff points.

Evaluating the Psychometric Properties of 3 Depression Measures in a Sample of Persons With Traumatic Brain Injury and Major Depressive Disorder

“…[32][33][34][35][36] Despite its frequent use, to date only 1 study has validated the 17-item HAM-D as a screen for MDD in a TBI sample. 37 The HAM-D had a sensitivity of 93% and specificity of 78% on the basis of a cut-point of 7. In people with stroke, the HAM-D has been found to be an adequate screening tool, but the measure also has several somatic symptoms that showed poor discriminant validity, 38 and the measure has performed worse with women than men and required adjustment to its standard cutoffs.…”

Predictors of Hospital Mortality and the Related Burden of Disease in Severe Traumatic Brain Injury: A Prospective Multicentric Study in Brazil

“…Traumatic brain injury (TBI) is a worldwide social, economic, and health problem related to premature death and long-term disabilities (1–5). Depending on the TBI severity and its complications, even in the absence of motor impairment, the TBI may result in cognitive deficits (6, 7), endocrine (8) and psychiatric disorders (9–11) affecting work capacity (12), and impairing the quality of life (9).…”

High serum levels of 8-OHdG are an independent predictor of post-stroke depression in Chinese stroke survivors

“… 30 Numerous studies have examined the high validity and utility of the HAMD-17 as a useful screening tool for depressive symptoms, and the optimal cutoff point has been found to be 7 in the general population or in patients with neurological diseases such as stroke, epilepsy, and severe traumatic brain injury. 31 – 34 …”