How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment
- 24 January 2006
- journal article
- Published by Springer Science and Business Media LLC in Diabetologia
- Vol. 49 (3), 469-477
- https://doi.org/10.1007/s00125-005-0094-2
Abstract
We compared the screening performance of different measures of depression: the standard clinical assessment (SCA); the Beck Depression Inventory (BDI); the Center of Epidemiological Studies-Depression Scale (CES-D); and the Problem Areas in Diabetes (PAID) questionnaire, which assesses diabetes-specific distress. We also studied the ability of these measures to detect diabetes-related distress. A total of 376 diabetic patients (37.2% type 1; 23.9% type 2 without insulin treatment, 38.8% type 2 with insulin) completed the BDI and CES-D; patients who screened positive participated in a diagnostic interview, the Composite International Diagnostic Interview (CIDI). Also, all patients completed the PAID questionnaire. Results of the SCA that related to depression diagnosis were reviewed to correct for false negative screening results. The prevalence of clinical depression was 14.1%, with an additional 18.9% of patients receiving a diagnosis of subclinical depression. Sensitivity for clinical depression in SCA (56%) was moderate, whereas BDI, CES-D and the PAID questionnaire showed satisfactory sensitivity (87, 79 and 81%, respectively). For subclinical depression, the sensitivity of the PAID questionnaire (79%) was sufficient, whereas that of SCA (25%) was poor. All methods showed low sensitivity for the detection of diabetes-specific emotional problems (SCA 19%, CIDI 34%, BDI 60%, CES-D 49%). The screening performance of SCA for clinical and subclinical depression was modest. Additional screening for depression using the PAID or another depression questionnaire seems reasonable. The ability of depression screening measures to identify diabetes-related distress is modest, suggesting that the PAID questionnaire could be useful when screening diabetic patients for both depression and emotional problems.This publication has 45 references indexed in Scilit:
- Serious diabetes-specific emotional problems and depression in a Croatian–Dutch–English Survey from the European Depression in Diabetes [EDID] Research ConsortiumDiabetes Research and Clinical Practice, 2005
- Affective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factorsDiabetic Medicine, 2005
- Standards of Medical Care in DiabetesDiabetes Care, 2005
- Rates and risks for co-morbid depression in patients with Type 2 diabetes mellitus: results from a community-based studyDiabetologia, 2003
- Communication patterns of primary care physicians in the United States and the NetherlandsJournal of General Internal Medicine, 2003
- A review of the relationship between depression and diabetes in adults: is there a link?Diabetes Care, 2000
- The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysisJournal of Affective Disorders, 2000
- Cognitive Behavior Therapy for Depression in Type 2 Diabetes MellitusAnnals of Internal Medicine, 1998
- Assessment of Diabetes-Related DistressDiabetes Care, 1995
- Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical reviewJournal of Psychiatric Research, 1994