Validity of the beck depression inventory, hospital anxiety and depression scale, SCL-90, and hamilton depression rating scale as screening instruments for depression in stroke patients.

Most instruments used to assess poststroke depression have never been specifically validated in stroke patients. This study evaluated the depression screening abilities of three questionnaires and one observer-rated scale in 202 consecutive patients 1 month after they experienced their first-ever ischemic stroke. At their respective optimum cutoff values, the sensitivity of the self-rated scales varied between 80% and 90%, while the specificity was about 60%. For the observer-rated scale (Hamilton Depression Rating Scale), sensitivity was 78.1%, and specificity was 74.6%. The instruments clearly performed better in men than in women. Despite this difference, it was concluded that all scales were acceptable screening instruments for poststroke depression.

[1]  K. Aho,et al.  Cerebrovascular disease in the community: results of a WHO collaborative study. , 1980, Bulletin of the World Health Organization.

[2]  M. Dennis,et al.  Detecting psychiatric morbidity after stroke: comparison of the GHQ and the HAD Scale. , 1998, Stroke.

[3]  K. Asplund,et al.  Major Depression in Stroke Patients: A 3‐Year Longitudinal Study , 1993, Stroke.

[4]  P. Enderby,et al.  Frenchay Aphasia Screening Test: validity and comparability. , 1996, Disability and rehabilitation.

[5]  G. Andersen,et al.  Incidence of post‐stroke depression during the first year in a large unselected stroke population determined using a valid standardized rating scale , 1994, Acta psychiatrica Scandinavica.

[6]  F. Verhey,et al.  The validity of the Hamilton and Montgomery‐Åsberg depression rating scales as screening and diagnostic tools for depression in Parkinson's disease , 2000, International journal of geriatric psychiatry.

[7]  R. Schulz,et al.  Assessment of depression in patients with brain pathology: the case of stroke. , 1997, Psychological bulletin.

[8]  A. House,et al.  Methods of identifying mood disorders in stroke patients: experience in the Oxfordshire Community Stroke Project. , 1989, Age and ageing.

[9]  J Bamford,et al.  A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981-86. 1. Methodology, demography and incident cases of first-ever stroke. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[10]  C. Anderson,et al.  Prevalence of Depression After Stroke: The Perth Community Stroke Study , 1995, British Journal of Psychiatry.

[11]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[12]  Mahoney Fi,et al.  FUNCTIONAL EVALUATION: THE BARTHEL INDEX. , 1965 .

[13]  A. House,et al.  Mood Disorders in the Year after First Stroke , 1991, British Journal of Psychiatry.

[14]  W. Arrindell,et al.  Dimensionele structuur, betrouwbaarheid en validiteit van de Nederlandse bewerking van de Symptom Checklist (SCL-90): Gegevens gebaseerd op een fobischen een "normale" populatie. , 1981 .

[15]  J. Rankin.  Cerebral Vascular Accidents in Patients over the Age of 60: II. Prognosis , 1957, Scottish medical journal.

[16]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[17]  D. Wade,et al.  Depressed Mood After Stroke , 1987, British Journal of Psychiatry.

[18]  C. Herrmann.  International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. , 1997, Journal of psychosomatic research.

[19]  C. Ross,et al.  Sex differences in distress: Real or artifact? , 1995 .

[20]  C. Anderson,et al.  Screening instruments for depression and anxiety following stroke: experience in the Perth community stroke study , 1995, Acta psychiatrica Scandinavica.

[21]  Heinrich Sauer,et al.  On the Validity of the Beck Depression Inventory , 1998, Psychopathology.

[22]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[23]  J. Lodder,et al.  Silent Brain Infarcts in 755 Consecutive Patients With a First‐Ever Supratentorial Ischemic Stroke: Relationship With Index‐Stroke Subtype, Vascular Risk Factors, and Mortality , 1994, Stroke.

[24]  L. Covi,et al.  SCL-90: an outpatient psychiatric rating scale--preliminary report. , 1973, Psychopharmacology bulletin.

[25]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[26]  A. House,et al.  Mood disorders after stroke: A review of the evidence , 1987 .

[27]  M. Sliwinski,et al.  Discriminative properties of somatic and nonsomatic symptoms for post stroke depression , 1996 .

[28]  M C Weinstein,et al.  Performance of screening and diagnostic tests. Application of receiver operating characteristic analysis. , 1987, Archives of general psychiatry.

[29]  H. Wellens,et al.  [Depression following a first heart infarct; similarities with and differences from 'ordinary' depression]. , 1997, Nederlands tijdschrift voor geneeskunde.

[30]  B. Caplan,et al.  Emotional Distress Following Stroke: Interpretive Limitations of the SCL-90-R , 1996 .

[31]  R. Robinson,et al.  Are depressive symptoms nonspecific in patients with acute stroke? , 1991, The American journal of psychiatry.