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The validity of questionnaire measures for assessing depression after stroke
N B Lincoln1, C R Nicholl, T Flannaghan
1School of Psychology, University of Nottingham, Nottingham, UK. Nadina.Lincoln@nottingham.ac.uk
Objective:
Depression has been reported to occur frequently after stroke. The aim of the study was to assess the validity of questionnaire measures for screening for depression after stroke.
Design:
Cross-sectional correlational study between questionnaire measures of mood and psychiatric interview.
Setting:
Hospital and community.
Participants:
Stroke patients were recruited from hospital wards and from a randomized controlled trial of cognitive behavioural therapy.
Main Measures:
Beck Depression Inventory, Wakefield Depression Inventory, General Health Questionnaire 28 and Schedules for Clinical Assessment in Neuropsychiatry.
Results:
Poor agreement was found between psychiatric diagnosis and questionnaire measures of mood. The sensitivity of the questionnaire measures was high, but specificity was low. No cut-off points with satisfactory sensitivity and specificity could be identified from ROC curves.
Conclusions:
Although questionnaire assessments of depression provide a satisfactory screening method, specificity values are too low to provide a basis for the diagnosis of depression. Measures need to be developed with higher specificity to facilitate screening for depression after stroke.