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The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis.
Mult Scler Relat Disord 2018; 20:9-15MS

Abstract

OBJECTIVE

We aimed to evaluate the validity and reliability of multiple screening measures for depression and anxiety for use in the clinical care of people with multiple sclerosis (MS).

METHODS

Participants with MS completed the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Kessler-6 Distress Scale, PROMIS Emotional Distress Depression Short-Form 8a (PROMIS Depression) and Anxiety Short-Form 8a (PROMIS Anxiety), Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Overall Anxiety and Severity Impairment Scale (OASIS). A subgroup repeated the screening measures two weeks later. All participants also completed a Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). For the screening measures we computed sensitivity, specificity, positive predictive and negative predictive value with SCID diagnoses as the reference standard and conducted receiver operating curve (ROC) analyses; we also assessed internal consistency and test-retest reliability.

RESULTS

Of 253 participants, the SCID classified 10.3% with major depression and 14.6% with generalized anxiety disorder. Among the depression measures, the PHQ-9 had the highest sensitivity (84%). Specificity was generally higher than sensitivity, and was highest for the HADS-D with a cut-point of 11 (95%). In ROC analyses the area under the curve (AUC) did not differ between depression measures. Among the anxiety measures, sensitivity was highest for the HADS-A with a cut-point of 8 (82%). Specificity ranged from 83% to 86% for all measures except the HADS-A with a cut-point of 8 (68%). The AUC did not differ between anxiety measures.

CONCLUSION

Overall, performance of the depression and anxiety screening measures was very similar, with reasonable psychometric properties for the MS population, suggesting that other factors such as accessibility and ease of use could guide the choice of measure in clinical practice.

Authors+Show Affiliations

Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. Electronic address: rmarrie@hsc.mb.ca.Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Nova Scotia Health Authority, Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, Canada.Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada.Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Psychiatry, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Clinical Health Psychology, Max Rady College of Medicine Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; Departments of Anesthesia & Perioperative Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Pub Type(s)

Journal Article
Validation Study

Language

eng

PubMed ID

29274564

Citation

Marrie, Ruth Ann, et al. "The Validity and Reliability of Screening Measures for Depression and Anxiety Disorders in Multiple Sclerosis." Multiple Sclerosis and Related Disorders, vol. 20, 2018, pp. 9-15.
Marrie RA, Zhang L, Lix LM, et al. The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis. Mult Scler Relat Disord. 2018;20:9-15.
Marrie, R. A., Zhang, L., Lix, L. M., Graff, L. A., Walker, J. R., Fisk, J. D., ... Bernstein, C. N. (2018). The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis. Multiple Sclerosis and Related Disorders, 20, pp. 9-15. doi:10.1016/j.msard.2017.12.007.
Marrie RA, et al. The Validity and Reliability of Screening Measures for Depression and Anxiety Disorders in Multiple Sclerosis. Mult Scler Relat Disord. 2018;20:9-15. PubMed PMID: 29274564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis. AU - Marrie,Ruth Ann, AU - Zhang,Lixia, AU - Lix,Lisa M, AU - Graff,Lesley A, AU - Walker,John R, AU - Fisk,John D, AU - Patten,Scott B, AU - Hitchon,Carol A, AU - Bolton,James M, AU - Sareen,Jitender, AU - El-Gabalawy,Renée, AU - Marriott,James J, AU - Bernstein,Charles N, Y1 - 2017/12/16/ PY - 2017/11/18/received PY - 2017/12/13/accepted PY - 2017/12/24/pubmed PY - 2018/9/7/medline PY - 2017/12/24/entrez KW - Anxiety KW - Depression KW - Multiple sclerosis KW - Psychometrics KW - Reliability KW - Validity SP - 9 EP - 15 JF - Multiple sclerosis and related disorders JO - Mult Scler Relat Disord VL - 20 N2 - OBJECTIVE: We aimed to evaluate the validity and reliability of multiple screening measures for depression and anxiety for use in the clinical care of people with multiple sclerosis (MS). METHODS: Participants with MS completed the Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Kessler-6 Distress Scale, PROMIS Emotional Distress Depression Short-Form 8a (PROMIS Depression) and Anxiety Short-Form 8a (PROMIS Anxiety), Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Overall Anxiety and Severity Impairment Scale (OASIS). A subgroup repeated the screening measures two weeks later. All participants also completed a Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). For the screening measures we computed sensitivity, specificity, positive predictive and negative predictive value with SCID diagnoses as the reference standard and conducted receiver operating curve (ROC) analyses; we also assessed internal consistency and test-retest reliability. RESULTS: Of 253 participants, the SCID classified 10.3% with major depression and 14.6% with generalized anxiety disorder. Among the depression measures, the PHQ-9 had the highest sensitivity (84%). Specificity was generally higher than sensitivity, and was highest for the HADS-D with a cut-point of 11 (95%). In ROC analyses the area under the curve (AUC) did not differ between depression measures. Among the anxiety measures, sensitivity was highest for the HADS-A with a cut-point of 8 (82%). Specificity ranged from 83% to 86% for all measures except the HADS-A with a cut-point of 8 (68%). The AUC did not differ between anxiety measures. CONCLUSION: Overall, performance of the depression and anxiety screening measures was very similar, with reasonable psychometric properties for the MS population, suggesting that other factors such as accessibility and ease of use could guide the choice of measure in clinical practice. SN - 2211-0356 UR - https://www.unboundmedicine.com/medline/citation/29274564/The_validity_and_reliability_of_screening_measures_for_depression_and_anxiety_disorders_in_multiple_sclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-0348(17)30347-4 DB - PRIME DP - Unbound Medicine ER -