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Am J Psychiatry 1997; 154:674-676
Copyright © 1997 by American Psychiatric Association
"Are you depressed?" Screening for depression in the terminally ill
HM Chochinov, KG Wilson, M Enns and S Lander
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
OBJECTIVE: This study compared the performance of four brief screening
measures for depression in a group of terminally ill patients. The methods
included 1) a single-item interview assessing depressed mood, 2) a two-item
interview assessing depressed mood and loss of interest in activities, 3) a
visual analog scale for depressed mood, and 4) the Beck Depression
Inventory-Short Form. METHOD: Semistructured diagnostic interviews for
depression were administered to 197 patients receiving palliative care for
advanced cancer. The interview diagnoses served as the standards against
which the screening performance of the four brief screening methods was
assessed. RESULTS: Single-item interview screening correctly identified the
eventual diagnostic outcome of every patient, substantially outperforming
the questionnaire and visual analog measures. CONCLUSIONS: Brief screening
measures for depression are important clinical tools for terminally ill
patients. For diagnostic purposes, however, they do not approach the
validity of a single-item interview that asks, in effect, "Are you
depressed?"
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