A preliminary investigation of the reliability and validity of the Brief Assessment Schedule Depression Cards and the Beck Depression Inventory‐Fast Screen to screen for depression in older stroke survivors

Healey, Anna K; Kneebone, Ian; Carroll, Martin; Anderson, Stuart

doi:10.1002/gps.1933

Cited by 42 publications

(25 citation statements)

References 20 publications

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“…[15][16][17][18][19][20] Unlike previous studies of these measures, we have included participants who varied in time since stroke and number of strokes, representing patients seen across a range of inpatient and outpatient services. Findings are therefore relevant for clinicians who see patients with stroke at both early and late stages of the recovery pathway.…”

Section: Discussionmentioning

confidence: 99%

Depression Screening in Stroke

Turner

Hambridge

White

et al. 2012

Stroke

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Background and Purpose— Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard. Methods— Seventy-two participants ≥3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures. Results— Internal consistency ranged from acceptable to excellent for all measures (Cronbach α=0.78–0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69–0.89) for the Kessler-10 to 0.89 (0.79–0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61–0.83), significantly smaller than the Beck Depression Inventory-II ( P <0.05). Conclusions— Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items.

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Section: Discussionmentioning

confidence: 99%

Depression Screening in Stroke

Turner

Hambridge

White

et al. 2012

Stroke

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“…While mean BDI scores in unselected cohorts of stroke patients were comparable to SCI (Fig. 2) the incidence of moderate to severe depressive symptoms in affected patients appear to be increased [14,15]. Two investigations in depressed stroke patients revealed mean BDIs of 17-18 (in 123 subjects) [25] respectively a mean BDI of about 20 in 74 patients [30].…”

Section: Comparison To Neurological Disordersmentioning

confidence: 97%

Low depressive symptoms in acute spinal cord injury compared to other neurological disorders

et al. 2011

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The aim of the study was to reveal the incidence and time course of depressive symptoms following acute spinal cord injury (SCI) in relation to clinical outcomes for comparison to other neurological disorders with severe impairment. In patients with acute traumatic SCI (n = 130), combined follow up assessments of neurological and functional outcomes, pain and patient-rated affective factors (e.g. mood, anxiety) were prospectively (1, 3, 6, 12 months after injury) collected during rehabilitation and follow up in out-patient clinics. We related these to the severity of depressive symptoms (no, mild, moderate and severe) based on the Beck Depression Inventory (BDI) scores. The mean 65% of patients showed no depressive symptoms and 30% mild depressive symptoms, while less than 5% presented moderate to severe depressive symptoms. The group findings and symptoms in individual patients remained stable over 1 year though patients revealed significant clinical recovery. Although two-thirds of the patients experienced pain, BDI scores were not related to pain intensity. BDI mean scores were only slightly higher than in control populations, but rather low compared to patients with other neurological disorders (e.g. stroke and multiple sclerosis) that are also associated with severe functional impairment. The prevalence of depressive symptoms following acute SCI is rather low and remains stable within the first year after injury despite the severe neurological impairment and loss of independency. In comparison to other neurological disorders that also involve brain function SCI patients seem to be less challenged by depressive symptoms that constitute additional burdens to respond to the severe functional impairments.

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“…In a recent clinical trial, Healey et al screened 49 elderly stroke patients for depression 77. They compared 3 depression scales: Brief Assessment Schedule Depression Cards (BASDEC), the Beck Depression Inventory-Fast Screen (BDI-FS), and the HADS.…”

Section: Screening and Evaluation Of Psdmentioning

confidence: 99%

Management of depression in elderly stroke patients

Lökk

Delbari²

2010

NDT

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Poststroke depression (PSD) in elderly patients has been considered the most common neuropsychiatric consequence of stroke up to 6–24 months after stroke onset. When depression appears within days after stroke onset, it is likely to remit, whereas depression at 3 months is likely to be sustained for 1 year. One of the major problems posed by elderly stroke patients is how to identify and optimally manage PSD. This review provides insight to identification and management of depression in elderly stroke patients. Depression following stroke is less likely to include dysphoria and more likely characterized by vegetative signs and symptoms compared with other forms of late-life depression, and clinicians should rely more on nonsomatic symptoms rather than somatic symptoms. Evaluation and diagnosis of depression among elderly stroke patients are more complex due to vague symptoms of depression, overlapping signs and symptoms of stroke and depression, lack of properly trained health care personnel, and insufficient assessment tools for proper diagnosis. Major goals of treatment are to reduce depressive symptoms, improve mood and quality of life, and reduce the risk of medical complications including relapse. Antidepressants (ADs) are generally not indicated in mild forms because the balance of benefit and risk is not satisfactory in elderly stroke patients. Selective serotonin reuptake inhibitors are the first choice of PSD treatment in elderly patients due to their lower potential for drug interaction and side effects, which are more common with tricyclic ADs. Recently, stimulant medications have emerged as promising new therapeutic interventions for PSD and are now the subject of rigorous clinical trials. Cognitive behavioral therapy can also be useful, and electroconvulsive therapy is available for patients with severe refractory PSD.

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A preliminary investigation of the reliability and validity of the Brief Assessment Schedule Depression Cards and the Beck Depression Inventory‐Fast Screen to screen for depression in older stroke survivors

Abstract: The BASDEC and BDI-FS were found to have acceptable reliability. The BASDEC demonstrated some advantage in criterion validity over the BDI-FS at the examined cut-offs.

Cited by 42 publications

References 20 publications

Depression Screening in Stroke

Depression Screening in Stroke

Low depressive symptoms in acute spinal cord injury compared to other neurological disorders

Management of depression in elderly stroke patients

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