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Design and Implementation of an fMRI Study Examining Thought Suppression in Young Women with, and At-risk, for Depression
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Problems with a diagnostic depression interview in a postpartum depression trial.

Dwenda Gjerdingen1, Patricia McGovern, Bruce Center

  • 1Department of Family Medicine and Community Health, University of Minnesota, St. Paul, MN 55103, USA. dgjerdin@umphysicians.umn.edu

Journal of the American Board of Family Medicine : JABFM
|March 9, 2011
PubMed
Summary
This summary is machine-generated.

Using diagnostic interviews like the Structured Clinical Interview for DSM Disorders (SCID) in postpartum depression trials can lead to selection bias. Alternative screening tools like the Patient Health Questionnaire (PHQ-9) may offer broader insights into depression symptoms.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Perinatal Mental Health

Background:

  • Diagnostic and Statistical Manual (DSM)-IV based depression interviews are crucial for treatment trials but can burden participants.
  • The Structured Clinical Interview for DSM Disorders (SCID) is a common diagnostic tool.
  • Participant burden is a significant consideration in clinical trial design.

Purpose of the Study:

  • To evaluate the use of the SCID depression module in a postpartum depression treatment trial.
  • To identify challenges and limitations associated with using the SCID in this population.
  • To compare SCID results with a self-report screening tool.

Main Methods:

  • A prospective cohort study involving 506 mothers from primary care clinics.
  • Participants completed the SCID depression module and the 9-item Patient Health Questionnaire (PHQ-9) at multiple postpartum time points.
  • Data collection occurred over 9 months postpartum.

Main Results:

  • Only 8.9% of women had a positive SCID diagnosis, compared to 22.1% positive PHQ-9 scores.
  • SCID noncompletion occurred in 14.8% of participants, with noncompleters being demographically disadvantaged.
  • Inconsistent SCID/PHQ-9 results were observed, with functionally impaired women sometimes having negative SCID scores.

Conclusions:

  • Mandatory diagnostic interviews like the SCID can introduce selection bias and lead to missed diagnoses in research.
  • The diagnostic accuracy of the SCID may be compromised by practical limitations in real-world research settings.
  • Researchers should carefully consider the implications of using DSM-IV-based interviews in clinical trials, especially in vulnerable populations.