Screening for depression in movement disorders clinic
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ORIGINAL ARTICLE
Screening for depression in movement disorders clinic Parviz Bahadoran 1
&
Rita Varela 1 & Andrea De Angelis 1 & Dominic Paviour 1 & Niruj Agrawal 1
Received: 4 February 2020 / Accepted: 2 July 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Depression is the most common, though often under-recognised, neuropsychiatric disturbance in movement disorders (MD). Objective This study aimed to establish whether a briefer screening measure such as a visual analogue screening measure (Emotions Thermometer) or Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) could be a potentially suitable screening tool for depression in MD patients. Method Patients attending a regional MD outpatient clinic completed the Emotional Thermometer 7-item tool (ET7), the Hospital Anxiety and Depression Scale (HADS) and the Neurological Disorders Depression Inventory for Epilepsy (NDDIE). We used the Major Depression Inventory which provided the diagnosis of depression based on ICD-10 and DSM-IV as our diagnostic gold standard to compare the performance of ET7 and its individual sub-scales, its briefer version ET4, HADS, and NDDIE. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operating characteristic curves were calculated to compare the performance of the screening tools. Results In total, 188 patients were included in the analysis. The most accurate tools as determined by Receiver Operating Characteristics curve were HADS-D for ICD-10 depressive episode and DepT for DSM-IV major depression. ET4 performed well as a ‘rule-out’ screening tool for both DSM-IV and ICD-10 depression. ET4 performance was comparable to HADS without the need for clinician scoring. The briefer ET4 performed almost as well as ET7. Conclusion Emotions Thermometer and NDDI-E are quick and reliable screening tools for depression in the MD population and are comparable to HADS. We suggest routine use of visual analogue ET4 as it is briefer, requires less time to complete and does not require scoring from the clinicians. It has the potential to be widely implemented across busy neurology clinics to assist in depression screening. Keywords Depression . Mood disorder . Diagnosis . Movement disorder . Parkinson’s disease . Neuropsychiatry
Introduction Parkinson’s disease (PD) is the second commonest neurodegenerative disorder [1, 2]. It affects approximately 1% of individuals over 55 [3], many of whom have clinically significant non-motor symptoms such as anxiety, depression, fatigue, sleep disturbance and sensory symptoms [4]. Depression is the commonest neuropsychiatric disturbance in PD [5], with an estimated prevalence of 35% [1, 6, 7]. It is the most important predictor of poor quality of life in PD [2]
* Parviz Bahadoran [email protected] 1
Atkinson Morley Regional Neurosciences Centre, St. George’s Hospital, London, UK
and the most significant factor associated with reduced quality of life [8], independently of motor symptoms [9]. It is associated with
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