Is it useful to ask “Está deprimido?” (“Are you depressed?”) to terminally-ill Portuguese patients? Results from outpatient research

Abstract Objectives: Depression is a serious psychological problem in the palliative care setting. Brief screening tools for depression are lacking and need to be brief and acceptable. This study aimed to identify the properties of the single Portuguese question “Está deprimido?” (“Are you depressed?”) to screen for depression. Methods: Retrospective study from 100 patient's medical records identifying the answers on the single Portuguese question for depression “Está deprimido?” (“Are you depressed?”) and the HADS depression sub-scale, using a score ≥11 on the latter as the gold standard for clinically significant depressive symptoms. Sensitivity, specificity, positive predictive and negative values were calculated. Results: Response rate for the single Portuguese question for depression was 100%. Prevalence of depression symptoms (HADS-d ≥ 11) was 43%. To the question “Está deprimido?” 60 patients responded “yes.” Sixteen patients who replied “no” to the single question had clinically significant depressive symptoms based on the HADS depression sub-scale. The single tool had 65.2% sensitivity, 49.2% specificity and 50.0% and 64.4% of positive predictive and negative values, respectively. Significance of results: In this first preliminary retrospective Portuguese study, the single question for depression has shown poor screening properties. Future research in larger and mixed patientś samples of Portuguese terminally ill is necessary to find more accurate and robust properties of this brief tool.

[1]  JuliãoMiguel,et al.  Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: a phase II randomized controlled trial. , 2014 .

[2]  Sonnenschein–van der Voort Agnes Mm,et al.  Breastfeeding is protective against early childhood asthma , 2013 .

[3]  B. Nunes,et al.  Time and life perception in the terminally ill: its utility in screening for depression. , 2013, Journal of palliative medicine.

[4]  B. Nunes,et al.  Efficacy of dignity therapy for depression and anxiety in terminally ill patients: Early results of a randomized controlled trial , 2013, Palliative and Supportive Care.

[5]  A. Martins,et al.  Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale , 2007, Psychology, health & medicine.

[6]  M. Lloyd-Williams,et al.  Is asking patients in palliative care, “Are you depressed?” appropriate? Prospective study , 2003, BMJ : British Medical Journal.

[7]  M. Hotopf,et al.  Depression in advanced disease: a systematic review Part 1. Prevalence and case finding , 2002, Palliative medicine.

[8]  S. Block,et al.  Assessing and Managing Depression in the Terminally Ill Patient , 2000, Annals of Internal Medicine.

[9]  Joaquín T. Limonero,et al.  A Way to Screen for Suffering in Palliative Care , 1997, Journal of palliative care.

[10]  H. Chochinov,et al.  "Are you depressed?" Screening for depression in the terminally ill. , 1997, The American journal of psychiatry.

[11]  S. Gravenstein,et al.  Screening for Depression: Single Question versus GDS , 1994, Journal of the American Geriatrics Society.

[12]  B. Nunes,et al.  Efficacy of Dignity Therapy on Depression and Anxiety in Portuguese Terminally Ill Patients : A Phase II Randomized Controlled Trial , 2014 .

[13]  S. Block Assessing and managing depression in the terminally ill patient. ACP-ASIM End-of-Life Care Consensus Panel. American College of Physicians - American Society of Internal Medicine. , 2000, Annals of internal medicine.