Appropriateness of the Ilfeld Psychiatric Symptom Index as a screening tool for depressive symptomatology in persons with spinal cord injury.
BACKGROUND
Depressive symptomatology is seen in some persons with spinal cord injury (SCI). Identification of a depressed mood can assist clinicians in early treatment. The Ilfeld Psychiatric Symptom Index (Ilfeld PSI) is a screening tool that assesses a range of symptoms: depression, cognitive disturbance, anxiety, and anger. The purpose of this study was to compare the efficacy of the Ilfeld PSI to the Zung Self-Rating Depression Scale (Zung SRS) in persons with chronic SCI.


METHODS
This was a case-control study.


METHODS
A total of 59 subjects completed the study: 20 persons with tetraplegia, 19 with paraplegia, and 20 age-matched able-bodied controls. The total scores for both measures were analyzed using Pearson correlation, analysis of variance, and chi-square tests.


RESULTS
The Zung SRS total scores correlated with the Ilfeld PSI subscales and index scores. When using the traditional cutoff scores, there was a low level of agreement between scales. The Ilfeld PSI classified 79% of the SCI group and 75% of controls as depressed. In contrast, 8% of the SCI group and none of the controls met criteria for depression using the Zung SRS.


CONCLUSIONS
The Ilfeld PSI screens for a broad range of symptoms; however, it poorly discriminates somatic symptoms unrelated to depression. Therefore, the Ilfeld PSI may not be a useful instrument for persons with SCI.
Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, Newark 07103, USA. campagno@umdnj.edu
Denise I
DI
Campagnolo
Rosemarie A
RA
Filart
Scott R
SR
Millis
Danielle E
DE
Lann
D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011782:Quadriplegia / Q000150:complications* / Q000523:psychology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology; D013997:Time Factors