title: Sensitivity and specificity of a two-question screening tool for depression in a specialist palliative care unit.
abstract: OBJECTIVE
  The primary objective in this study is to determine the sensitivity and specificity of a two-item screening interview for depression versus the formal psychiatric interview, in the setting of a specialist palliative in-patient unit so that we may identify those individuals suffering from depressive disorder and therefore optimise their management in this often-complex population.
  
  
  METHODS
  A prospective sample of consecutive admissions (n = 167) consented to partake in the study, and the screening interview was asked separately to the formal psychiatric interview.
  
  
  RESULTS
  The two-item questionnaire, achieved a sensitivity of 90.7% (95% CI 76.9-97.0) but a lower specificity of 67.7% (95% CI 58.7-75.7). The false positive rate was 32.3% (95% CI 24.3-41.3), but the false negative rate was found to be a low 9.3% (95% CI 3.0-23.1). A subgroup analysis of individuals with a past experience of depressive illness, (n = 95), revealed that a significant number screened positive for depression by the screening test, 55.2% (16/29) compared to those with no background history of depression, 33.3% (22/66) (P = 0.045).
  
  
  CONCLUSIONS
  The high sensitivity and low false negative rate of the two-question screening tool will aid health professionals in identifying depression in the in-patient specialist palliative care unit. Individuals, who admit to a previous experience of depressive illness, are more likely to respond positively to the two-item questionnaire than those who report no prior history of depressive illness (P = 0.045).
authors.affiliation: Cork University Hospital, Cork, Ireland. dannann@eircom.net
authors.forename: Ann
authors.initials: A
authors.lastname: Payne
authors.forename: Sandra
authors.initials: S
authors.lastname: Barry
authors.forename: Brian
authors.initials: B
authors.lastname: Creedon
authors.forename: Carol
authors.initials: C
authors.lastname: Stone
authors.forename: Catherine
authors.initials: C
authors.lastname: Sweeney
authors.forename: Tony
authors.initials: T
authors.lastname: O' Brien
authors.forename: Kathleen
authors.initials: K
authors.lastname: O' Sullivan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires