The assessment of depression in aphasic stroke patients: the development of the Stroke Aphasic Depression Questionnaire

Sutcliffe, Louise; Lincoln, Nadina B.

doi:10.1191/026921598672167702

Cited by 154 publications

(146 citation statements)

References 23 publications

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“…A key difference between the PHQ-9 and other depression scales is that it is based on the 9 DSM-IV symptoms of depression, which facilitates its use as a depression diagnostic tool as well as a screening instrument. Further, although other scales may perform differently in different ethnic groups or among patients of different age or gender, 23,24 this critical aspect of scale measurement is infrequently assessed. We found that the PHQ-9 performed equally well regardless of age, gender, or ethnicity, suggesting that it can be confidently used even in a heterogeneous group of patients.…”

Section: Discussionmentioning

confidence: 99%

Performance of the PHQ-9 as a Screening Tool for Depression After Stroke

Williams

Brizendine

Plue

et al. 2005

Stroke

326

275

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Background and Purpose-The purpose of this study was to examine the performance of the Patient Health Questionnaire (PHQ)-9, a 9-item depression scale, as a screening and diagnostic instrument for assessing depression in stroke survivors. Methods-As part of a randomized treatment trial for poststroke depression (PSD), subjects with and without PSD completed the PHQ-9, a 9-item summed scale, with scores ranging from 0 (no depressive symptoms) to 27 (all symptoms occurring daily). Subjects endorsing 2 or more symptoms of depression were administered the criterion standard Structured Clinical Interview for Depression (SCID). Receiver operating characteristic analysis was used to examine the sensitivity and specificity of the PHQ-9 Results-Of 316 subjects enrolled, 145 met SCID criteria for major depression or other depressive disorder, and 171 were not depressed. PHQ-9 scores discriminated well between subjects with any versus no depressive disorder, with an area under the curve (AUC) of 0.96, as well as between subjects with and without major depression (AUCϭ0.96). The AUC was similar regardless of patient age, gender, or ethnicity. A PHQ-9 score Ն10 had 91% sensitivity and 89% specificity for major depression, and 78% sensitivity and 96% specificity for any depression diagnosis. Conclusions-The PHQ-9 performs well as a brief screener for PSD with operating characteristics similar or superior to other depression measures and similar to its characteristics in a primary care population. Moreover, PHQ-9 scores discriminate equally well between those with and without PSD regardless of age, gender, or ethnicity. Key Words: depression Ⅲ stroke P oststroke depression (PSD) affects approximately onethird of ischemic stroke survivors, is often undiagnosed and inadequately treated, and is associated with increased morbidity and mortality after stroke. 1-4 Depression screening after stroke is thus important but can be complicated by cognitive and physical symptoms of stroke that may introduce additional variability in assessment of depressive symptoms and depression diagnosis. Although several established depression screening instruments have been validated in stroke cohorts, 5-10 these scales can be burdensome for patients to complete, require a trained interviewer to administer, and often are designed only for screening and not as a diagnostic depression tool. The Patient Health Questionnaire 9-item depression scale (PHQ-9) is a 9-item self-administered depression screening and diagnostic tool increasingly used in primary care and other medical populations. 11,12 Although it has excellent measurement properties in other settings, it has not been previously validated in patients with PSD. The purpose of this study was to examine the performance of the PHQ-9 as a screening and diagnostic instrument for assessing depression in ischemic stroke survivors. Subjects and MethodsSubjects were patients enrolled in the National Institute for Neurologic Disorders and Stroke-funded AIM (Activate, Initiate treatment, Monitor) PSD study....

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Section: Discussionmentioning

confidence: 99%

Performance of the PHQ-9 as a Screening Tool for Depression After Stroke

Williams

Brizendine

Plue

et al. 2005

Stroke

326

275

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“…), though it does not imply a diagnosis of the condition, similar to alternative depression rating scales. 28 The WDI has previously been used with success in studies investigating depression in patients with other pathologies 29,30 and, furthermore, can independently be completed by the patient, reducing investigator bias.…”

Section: Outcome Measuresmentioning

confidence: 99%

Depression in patients with idiopathic pulmonary fibrosis

2013

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Depression carries enormous global morbidity and is 1.5-7 times likelier to occur in individuals with chronic illness than in the general population. Idiopathic pulmonary fibrosis (IPF) has a rising incidence with a severe impact on quality of life. An indication of the prevalence of depression in this group is therefore of paramount interest. A prospective study was performed. A total of 118 participants with IPF who attended the interstitial lung disease clinic in Ninewells Hospitals, Dundee, Scotland, from May 2010 to September 2011 were recruited. Informed consent was obtained. The male to female ratio was 60:58. The Wakefield Self-assessment of Depression Inventory was used (scores !15 denote a depressed state). Pulmonary function tests were measured to correlate disease severity with depression scores. Of them, 58 patients had significant depressive symptoms scoring !15; only nine were taking antidepressant medication. The mean depression score of female participants was 15.0 + 0.77 (SD 5.9), compared with a mean male score of 13.1 + 0.99 (SD 7.5). Disease severity, age, duration since diagnosis and number of co-morbidities were not significantly correlated with depression. The study population had a high prevalence of depressive symptoms. Medical therapy for pulmonary fibrosis is limited and therefore palliation of symptoms and pulmonary rehabilitation form the main strategy for management. Depression should be actively screened in patients with IPF.

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“…A score Ն14 out of a possible 30 was considered a positive sign of depression. The Stroke Aphasic Depression Questionnaire has been validated against Hospital Anxiety and Depression Scale in community patients with stroke 17 and in a care home setting. 12 Each complication was considered as a single dichotomous (present/absent) variable.…”

Section: Depressionmentioning

confidence: 99%

The Prevalence of Joint Contractures, Pressure Sores, Painful Shoulder, Other Pain, Falls, and Depression in the Year After a Severely Disabling Stroke

Sackley

Brittle²,

Patel³

et al. 2008

Stroke

203

118

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Background and Purpose-Complications after stroke have been shown to impede rehabilitation, lead to poor functional outcome, and increase cost of care. This inception cohort study sought to investigate the prevalence of immobilityrelated complications during the first year after severely disabling stroke in relation to functional independence and place of residence. Methods-Over a 7-month period, 600 stroke survivors were identified in the hospital through the Nottingham Stroke Register.Those who had a Barthel Index score Յ10 3 months poststroke and did not have a primary diagnosis of dementia were eligible to participate in the study. Assessments of complications were carried out at 3, 6, and 12 months poststroke. Results-Complications were recorded for 122 stroke survivors (mean age, 76 years; 57% male). Sixty-three (52%) had significant language impairment and of the remaining 59 who were able to complete an assessment of cognitive function, 10 (8%) were cognitively impaired. The numbers of reported complications over 12 months, in rank order, were falls, 89 (73%); contracture, 73 (60%); pain, 67 (55%); shoulder pain, 64 (52%); depression, 61 (50%); and pressure sores, 26 (22%). A negative correlation was found between Barthel Index score and the number of complications experienced (low scores on the Barthel Index correlate with a high number of complications). The highest relative percentages of complications were experienced by patients who were living in a nursing home at the time of their last completed assessment. Conclusions-Immobility-related complications are very common in the first year after a severely disabling stroke.Patients who are more functionally dependent in self-care are likely to experience a greater number of complications than those who are less dependent.

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The assessment of depression in aphasic stroke patients: the development of the Stroke Aphasic Depression Questionnaire

Abstract: The SADQ may be used for assessing depressed mood in aphasic patients in the community though further validation is required.

Cited by 154 publications

References 23 publications

Performance of the PHQ-9 as a Screening Tool for Depression After Stroke

Performance of the PHQ-9 as a Screening Tool for Depression After Stroke

Depression in patients with idiopathic pulmonary fibrosis

The Prevalence of Joint Contractures, Pressure Sores, Painful Shoulder, Other Pain, Falls, and Depression in the Year After a Severely Disabling Stroke

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