To determine if there is a core subset of depressive symptoms that could be used to efficiently diagnose depression after administering the 2-item PRIME-MD a screening questionnaire for depression.
One thousand patients selected randomly and by convenience from 4 primary care clinics were assessed by PRIME-MD and completed a questionnaire measuring the following validation variables : functional status and well-being, disability days, somatic symptoms, depression severity, suicidal thoughts, health care utilization, and the physician-patient relationship.
Four symptoms (sleep disturbance, anhedonia, low self-esteem, and decreased appetite) accounted for virtually all the depression symptom-related variance in functional status and well-being, with 8.3% of patients having 2 of these symptoms and 8.2% having 3 or 4 of these symptoms.
There was excellent agreement between diagnosis based on core symptoms and major depression (K=0.77 ; overall accuracy rate, 94%). There were significant differences (P<. 001) among patients with negative depression screen, 0 to 1,2, and 3 to 4 core symptoms with scores on each of the validation variables getting progressively worse in these 4 groups.
A cutoff point of 2 core symptoms identified all but 3 patients with major depression and an additional 5% of the entire sample without major depression who were significantly (P<. 05) worse than patients without depression on each of the validation variables. (...)
Mots-clés Pascal : Etat dépressif, Dépistage, Questionnaire, Symptôme positif, Identification, Evaluation, Soin santé primaire, Faisabilité, Homme, Système nerveux pathologie, Psychopathologie, Psychiatrie, Organisation santé, PRIME-MD
Mots-clés Pascal anglais : Depression, Medical screening, Questionnaire, Positive symptom, Identification, Evaluation, Primary health care, Feasibility, Human, Nervous system diseases, Psychopathology, Psychiatry, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0051699
Code Inist : 002B18C07A. Création : 31/05/1999.