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Comparison of assessment measures for post-stroke depression
Patricia Ryan Roger1, Doug Johnson-Greene
1Johns Hopkins University School of Medicine, Department of Physical Medicine and Rehabilitation, Division of Rehabilitation Psychology and Neuropsychology, Baltimore, MD 21239, USA. johnsong@jhmi.edu
The Clinical Neuropsychologist
|March 17, 2009
Summary
Detecting depression after stroke is crucial. This study found that common depression screening tools may not be sensitive enough for stroke survivors, recommending specific adjustments for better accuracy.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Post-stroke depression is common, increasing patient morbidity and mortality.
- Accurate depression assessment in stroke survivors is vital for timely intervention.
- Existing depression screening tools may have limitations in this specific population.
Purpose of the Study:
- To evaluate the sensitivity and specificity of four standardized depression measures in acute stroke patients.
- To compare the diagnostic accuracy of different depression assessment tools in a post-stroke cohort.
- To identify optimal screening thresholds for depression in individuals following a stroke.
Main Methods:
- Cross-sectional study of 67 acute stroke patients in an inpatient rehabilitation unit.
- Assessment using four standardized depression scales and a structured clinical interview based on DSM-IV criteria.
- Receiver operating curve (ROC) analyses to adjust cutoff scores and evaluate positive predictive value (PPV).
Main Results:
- Major depression affected 15% and minor depression 28% of the sample.
- The four measures, using standard thresholds, reported depression rates from 14% to 46%.
- Adjusting cutoff scores via ROC analysis improved PPV for all measures, ranging from 28% to 34%.
Conclusions:
- Standard depression assessment measures show varying classification rates in acute stroke patients.
- Traditional thresholds may lack optimal sensitivity for detecting depression in stroke populations.
- The Geriatric Depression Scale-Short Form with a cutoff score of 3 or greater is recommended for clinicians.
