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Validation of self-report depression rating scales in Huntington's disease

Jennifer De Souza1, Lisa A Jones, Hugh Rickards

  • 1Birmingham and Solihull Mental Health Foundation Trust, Neuropsychiatry Service, Birmingham B15 2FG, United Kingdom. jck543@bham.ac.uk

Movement Disorders : Official Journal of the Movement Disorder Society
|November 13, 2009
PubMed

Insights

The Hospital Anxiety and Depression Scale (HADS-D) and Depression Intensity Scale Circles (DISCs) effectively screen for depression in Huntington's disease patients. The DISCs may be better for those with cognitive impairments.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Huntington's disease (HD) is a neurodegenerative disorder with significant psychiatric manifestations.
  • Depression is a common and debilitating comorbidity in HD patients, impacting quality of life.
  • Accurate assessment of depression is crucial for timely intervention in HD.

Purpose of the Study:

  • To evaluate the criterion validity of three self-report depression measures in individuals with Huntington's disease.
  • To compare the diagnostic accuracy of the Beck Depression Inventory-II (BDI-II), Hospital Anxiety and Depression Scale (HADS), and Depression Intensity Scale Circles (DISCs) against ICD-10 criteria.
  • To identify the most suitable screening tools for depression in the HD population.

Main Methods:

  • Fifty patients with Huntington's disease completed the BDI-II, HADS, and DISCs.
  • Psychiatric status was assessed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).
  • Receiver operating characteristic (ROC) curve analysis was used to determine sensitivity, specificity, and predictive values, with ICD-10 diagnosis as the gold standard.

Main Results:

  • Twenty-four percent of HD patients met ICD-10 criteria for a depressive disorder.
  • The HADS depression subscale (HADS-D) demonstrated maximal discrimination between depressed and non-depressed patients at a cut-off score of 6/7.
  • The DISCs performed well at a cut-off of 1/2, particularly for patients with severe cognitive or communicative deficits, while the BDI-II showed the least satisfactory performance.

Conclusions:

  • The HADS-D and DISCs are validated and effective screening tools for depression in individuals with Huntington's disease.
  • The DISCs may offer advantages in assessing depression among HD patients with significant communication or cognitive challenges.
  • These findings support the use of HADS-D and DISCs in routine clinical assessments of depression in HD populations.

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