title: Comparison of the SF-36 Five-item Mental Health Inventory and Beck Depression Inventory for the screening of depressive symptoms in chronic dialysis patients.
abstract: BACKGROUND
  The Beck Depression Inventory (BDI) is a standard and validated questionnaire to screen for depressive symptoms in chronic dialysis patients, but is relatively extensive to use repeatedly in clinical practice. We investigated whether the five-item Mental Health Inventory (MHI-5) of the 36-item Short-Form Health Survey Questionnaire (SF-36) could be applied to screen for depressive symptoms in dialysis patients. Moreover, we determined the optimal MHI-5 cut-off score to assess depressive symptoms.
  
  
  METHODS
  Chronic dialysis patients from three centres filled out the SF-36 and the BDI. A receiver operating characteristic (ROC) curve was constructed for the MHI-5 score with BDI ≥ 16 as reference standard to (i) calculate the area under the curve to determine whether the MHI-5 could be considered as a useful screening instrument for depressive symptoms and (ii) proxy the optimal cut-off score of the MHI-5 to assess depressive symptoms. The optimal cut-off score was determined by the value for which the sum of sensitivity and specificity had an optimum.
  
  
  RESULTS
  Of 133 included patients, 23% had depressive symptoms as determined with BDI ≥ 16. The correlation of the BDI with MHI-5 was -0.64. The area under the ROC curve was 0.82 (95% confidence interval 0.74-0.90). The optimal cut-off point of the MHI-5 was 70. MHI-5 ≤ 70 had 77 sensitivity, 72 specificity, 44 positive predicting value and 91% negative predicting value with the presence of depressive symptoms determined with BDI ≥ 16.
  
  
  CONCLUSIONS
  The MHI-5 may help clinicians to screen for depressive symptoms in dialysis patients without using an additional depression screening questionnaire once the SF-36 is completed. A cut-off value of 70 can be used safely for the purposes of screening applications.
authors.affiliation: Department of Nephrology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands. tessa_van_den_beukel@hotmail.com
authors.forename: Tessa O
authors.initials: TO
authors.lastname: van den Beukel
authors.forename: Carl E H
authors.initials: CE
authors.lastname: Siegert
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dijk
authors.forename: Pieter M
authors.initials: PM
authors.lastname: Ter Wee
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.forename: Adriaan
authors.initials: A
authors.lastname: Honig
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D006435:Renal Dialysis / Q000009:adverse effects* / Q000523:psychology*; D011795:Surveys and Questionnaires