Cognitive‐based measures screening for depression in the medically ill: the DMI‐10 and the DMI‐18

Abstract

Objective: We suggest that the identification of depression in the medically ill (DMI) might be improved by focussing on cognitive features. Method: We recruited 302 patients to complete our provisional cognitive‐based measure. Subsets also completed one of two comparator screening measures, either the Hospital and Anxiety Depression Scale (HADS) or the Beck Depression Inventory for Primary Care (BDI‐PC). One hundred and sixty patients were then assessed by a psychiatrist who estimated whether they were `clinically depressed' and who also administered a standardized interview for depression (the CIDI). Results: Analyses identified items discriminating clinically depressed and non‐depressed individuals, allowing development of brief (10‐item) and extended (18‐item) measures. The two new measures were compared with the HADS and the BDI‐PC in discriminating depressed and non‐depressed medically ill patients. Conclusion: A cognitive construct‐based approach to assessing depression in the medically ill appears strongly supported. We provide brief (DMI‐10) and extended (DMI‐18) measures that appear to have utility as screening instruments. Consideration of the discriminating items may also assist clinical decision making.

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

“…This underlines the central role of cognitive symptoms and depressed mood in any attempt to screen accurately for depression in somatic patients (Parker et al, 2002;Clark et al, 1998). These results provide additional confirmation of the value of using anxiety symptoms when measuring depression and are consistent with studies in the medically ill suggesting that HAD-A performs well in screening for depression (Strik et al, 2001;Katz et al, 2004).…”

Gender differences in depression severity and symptoms across depressive sub-types

“…Patients additionally completed the Mood Assessment Programme or MAP (Parker et al, 2008), a computerised tool assessing a range of features including socio-demographic, mood disorder and treatment history details. The MAP also contains a number of validated self-report measures of depressive symptomatology, including the Depression in the Medically Ill-10 measure (DMI-10; Parker et al, 2002), the Severity of Depressive Symptoms measure (SDS; Parker et al, 2009; and the Sydney Melancholia Prototype Index SMPI (Parker et al, 2012(Parker et al, , 2013b. All measures are detailed shortly.…”

“…The DMI-10 (Parker et al, 2002) was designed to detect state depression severity in patients with medical disorders, and to respect and redress concerns that such patients might score falsely high on somatic symptoms such as insomnia, fatigue and weight loss (due to their medical illness rather than concomitants of depression), and so comprises 10 non-somatic depressed mood constructs. Scores for each item range from 0-3, with total scores ranging from 0-30 (a score of 9 or above being identified as indicative of 'clinical depression').…”

Is there a role forn-3 long-chain polyunsaturated fatty acids in the regulation of mood and behaviour? A review of the evidence to date from epidemiological studies, clinical studies and intervention trials

“…Hallahan et al (126) also found a beneficial effect of EPA þ DHA supplementation on the presence or absence of suicidal ideation. However, one study also found no improvement in depression ALA, a-linolenic acid; DPA, docosapentaenoic acid; LA, linoleic acid; AA, arachidonic acid; C, clinical; BDI, Beck Depression Inventory (53) ; PCPG, plasma choline phosphoacylglycerols; þ, positive correlation; x, no correlation; HDRS, Hamilton Depression Rating Scale (93) ; CE, plasma cholesteryl esters; PL, plasma phospholipids; EM, erythrocyte membranes; 2, negative correlation; DMI-18, Depression in the Medically Ill (eighteen-item version) (94) ; NC, non-clinical; ZSDS, Zung Self-Rating Depression Scale (84) ; AT, adipose tissue; CES-D, Center for Epidemiologic Studies (depression scale) (57) ; GDS-15, Geriatric Depression Scale (fifteen-item version) (85) ; EPDS, Edinburgh Postnatal Depression Scale (58) ; IBS, irritable bowel syndrome; SCL, Symptom Checklist (ninety-item version) (95) ; HADS-D, Hospital Anxiety and Depression Scales (depression scale) (55) ; MADRS, Montgomery -Asberg Depression Rating Scale (96) ; mol*, concentration calculated with references to the internal standard 18-methylnonadecanoic acid; SIS, Suicide Intent Scale (97) ; L, plasma lipids.…”