'A no means no'--measuring depression using a single-item question versus Hospital Anxiety and Depression Scale (HADS-D).
BACKGROUND
Depression often develops undetected; to make treatment possible, a single-item screening question may be useful.


METHODS
We attempted to compare the accuracy of the single-item question 'Are you depressed?' with the seven-item Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) among 1192 Swedish testicular cancer survivors.


RESULTS
We obtained information from 974 men (82%). Fifty-nine men (6%) answered 'Yes' to the question 'Are you depressed?' while 118 (12%) answered 'I don't know' and 794 (82%) answered 'No'. Among the 794 men who answered 'No' to the question 'Are you depressed?', 790 (99.5%) were not considered as depressed according to HADS-D 11+. Of those answering 'Yes', 34% (20/59) were identified as depressed according to the same cut-off. Sensitivity of 'Yes' compared with HADS-D > or =11 was 61%, rising to 88% when 'Yes' and 'I don't know' were combined.


CONCLUSIONS
In a population of men with a prevalence of depression similar to that of the normal population, almost none of those responding 'No' to the written question 'Are you depressed?' were depressed according to HADS-D > or =11. Adding the category 'I don't know' increases sensitivity in detecting depression.
Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy; Department of Psychology, The Sahlgrenska Academy, Gothenburg. Electronic address: johanna.skoogh@oncology.gu.se.
J
J
Skoogh
Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy.
N
N
Ylitalo
Institution of Clinical Neuroscience, Department of Psychiatry; Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
P
P
Larsson Omeróv
Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
A
A
Hauksdóttir
Institution of Clinical Neuroscience, Department of Psychiatry; Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
U
U
Nyberg
Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy.
U
U
Wilderäng
Department of Psychology, The Sahlgrenska Academy, Gothenburg.
B
B
Johansson
Department of Psychology, University of Southern California, Los Angeles, CA, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
M
M
Gatz
Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy; Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
G
G
Steineck
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D005500:Follow-Up Studies; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013548:Sweden; D013736:Testicular Neoplasms / Q000523:psychology*; D055815:Young Adult