Cognitive-based measures screening for depression in the medically ill: the DMI-10 and the DMI-18.
OBJECTIVE
We suggest that the identification of depression in the medically ill (DMI) might be improved by focussing on cognitive features.


METHODS
We recruited 302 patients to complete our provisional cognitive-based measure. Subsets also completed one of two comparator screening measures, either the Hospital and Anxiety Depression Scale (HADS) or the Beck Depression Inventory for Primary Care (BDI-PC). One hundred and sixty patients were then assessed by a psychiatrist who estimated whether they were 'clinically depressed' and who also administered a standardized interview for depression (the CIDI).


RESULTS
Analyses identified items discriminating clinically depressed and non-depressed individuals, allowing development of brief (10-item) and extended (18-item) measures. The two new measures were compared with the HADS and the BDI-PC in discriminating depressed and non-depressed medically ill patients.


CONCLUSIONS
A cognitive construct-based approach to assessing depression in the medically ill appears strongly supported. We provide brief (DMI-10) and extended (DMI-18) measures that appear to have utility as screening instruments. Consideration of the discriminating items may also assist clinical decision making.
Parker
G
G
School of Psychiatry, University of New South Wales, and Mood Disorders Unit, Prince of Wales Hospital, Sydney, Australia.
Hilton
T
T
Bains
J
J
Hadzi-Pavlovic
D
D
D002908:Chronic Disease / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology*; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires