Screening for major depression in the early stages of multiple sclerosis.
BACKGROUND
Multiple Sclerosis (MS) is associated with a high risk of developing major depression, but depression in MS patients frequently goes undetected and untreated. The current study examined the clinical utility of the Beck Depression Inventory (BDI) as a screening measure for major depression in newly diagnosed MS patients.


METHODS
Forty-six new referrals to an MS clinic completed the BDI and participated in a structured interview for major depression, within 2 months of the diagnosis of MS.


RESULTS
According to DSM-III-R criteria, 40% of patients were diagnosed with major depression, 22% had adjustment disorder with depressed mood, and 37% showed no evidence of mood disorder. Sensitivity and specificity values, and positive and negative predictive values are reported for every BDI cut-off score between 9 and 21.


CONCLUSIONS
A BDI cut-off score of 13 (sensitivity = .71, specificity = .79) is recommended as optimal for use in screening for major depression in newly diagnosed MS patients. The use of the BDI as a screening measure for major depression must proceed with caution given that a cut-off score of 13 still yielded a false-negative rate of 30%.
Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada.
M J
MJ
Sullivan
B
B
Weinshenker
S
S
Mikail
S R
SR
Bishop
D000328:Adult; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012680:Sensitivity and Specificity