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Optimizing screening for depression among adults with asthma.

Annik Plourde1,2,3, Gregory Moullec3,4,5, Simon L Bacon1,3,6

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Summary

The Beck Depression Inventory II (BDI-II) effectively screens for major depressive disorder (MDD) in asthma patients. Optimal cut-off scores vary by individual characteristics, emphasizing the need for population-specific validation.

Keywords:
Beck Depression Inventory IIDepressive symptomsdiagnostic accuracysensitivityspecificity

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Area of Science:

  • Psychiatry
  • Pulmonology
  • Clinical Psychology

Background:

  • The Beck Depression Inventory II (BDI-II) is widely used for depression screening in chronic conditions like cardiovascular disease and asthma.
  • Existing BDI-II cut-off scores lack validation specifically for adult asthmatic populations.

Purpose of the Study:

  • To establish the optimal BDI-II cut-off score for identifying major depressive disorder (MDD) in adult asthmatics.
  • To assess how sociodemographic and clinical factors influence the accuracy of BDI-II screening in this population.

Main Methods:

  • 801 adult asthmatic outpatients completed the BDI-II and a structured psychiatric interview for MDD diagnosis.
  • Sensitivity and specificity analyses determined the optimal BDI-II cut-off score.
  • Subgroup analyses examined score variations based on sex, age, smoking status, and asthma control.

Main Results:

  • 13% of participants were diagnosed with current MDD.
  • An overall optimal BDI-II cut-off score of 12 was identified (85% sensitivity, 79% specificity).
  • Optimal cut-off scores varied between 11 and 15 across different patient subgroups.

Conclusions:

  • The BDI-II is a suitable screening tool for MDD in asthma patients.
  • Sociodemographic and clinical characteristics impact the BDI-II cut-off score, necessitating tailored validation.
  • Generic depression screening tools require validation in specific patient populations to enhance diagnostic accuracy.