title: Recognizing depression in patients with Parkinson's disease: accuracy and specificity of two depression rating scale.
abstract: This study aimed to find cut-off scores for the Montgomery-Asberg rating scale (MADRS) and the Beck depression inventory (BDI) that can relate to specific clinical diagnoses of depression in Parkinson s disease (PD). Mild and moderate PD patients (n=46) were evaluated for depression according to the DSM IV criteria. All patients were assessed with the MADRS and the BDI. A "receiver operating characteristics" (ROC) curve was obtained and the sensibility, specificity, positive and the negative predictive values were calculated for different cut-off scores of the MADRS and the BDI. The Kappa statistic was calculated for different cut-off scores to assess the agreement between the clinical judgment and both scales. Depression was present in 18 patients. MADRS cut-off scores of 6 and 10 showed Kappa 0.5 and 0.56, respectively. Specificity of cut-off score of 6 was 78.6% and of cut-off score of 10 was 96.4%. Kappa agreement of BDI cut-off scores of 10 and 18 were 0.36 and 0.62, respectively. Specificity was 60.7% for 10 and 92.9% for 18. Both rating scales show similar accuracy within the ROC curves (84.3% for MADRS and 79.7% for BDI). The MADRS and the BDI show a good accuracy and correlation to the clinical diagnosis when a cut-off score of 10 is used to MADRS and a cut-off score of 18 is used to BDI to recognize depression in mild to moderate PD patients. This may help clinicians to recognize depression in PD.
authors.affiliation: Center for Alzheimer's Disease in Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Barata Ribeiro 774/407, 22051-000 Rio de Janeiro RJ, Brazil. cdsil@terra.com.br
authors.forename: Cláudia Débora
authors.initials: CD
authors.lastname: Silberman
authors.forename: Jerson
authors.initials: J
authors.lastname: Laks
authors.forename: Cláudia Figueiredo
authors.initials: CF
authors.lastname: Capitão
authors.forename: Cláudia Soares
authors.initials: CS
authors.lastname: Rodrigues
authors.forename: Irene
authors.initials: I
authors.lastname: Moreira
authors.forename: Eliasz
authors.initials: E
authors.lastname: Engelhardt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index