title: Comparative validity of depression assessment scales for screening poststroke depression.
abstract: BACKGROUND
  This study aimed to compare screening properties of four assessment scales for poststroke depression (PSD) at 2 weeks and 1 year after index stroke, and investigated factors contributing to misclassification.
  
  
  METHODS
  A total of 423 patients were evaluated 2 weeks after stroke and 288 (68%) were followed 1 year later, and were diagnosed as having major and minor PSD applying DSM-IV criteria gold standards. The Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale-depression subscale (HADS-D), Hamilton Rating Scale for Depression (HAMD), and Montgomery-Asberg Depression Rating Scale (MADRS) were administered. The balance of sensitivity and specificity was assessed using receiver operating characteristics (ROC) analysis.
  
  
  RESULTS
  Discriminating abilities of all the scales for major and all PSD were good (area under ROC values 0.88-0.93 and 0.88-0.92 at 2 weeks; and 0.93-0.96 and 0.89-0.91 at 1 year, respectively). Misclassification was influenced by demographic characteristics and stroke severity particularly for the BDI and HAMD, was more marked for all PSD than for major PSD, and was more prominent at 2 weeks than at 1 year after stroke.
  
  
  CONCLUSIONS
  Patients with only mild to moderate stroke severity were included.
  
  
  CONCLUSIONS
  Although there were no marked differences in the screening abilities for PSD between the scales, differences were found in factors influencing misclassification. Assessment scales with less somatic items may be recommended for the screening of PSD, particularly at the acute phase of stroke.
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Hee-Ju
authors.initials: HJ
authors.lastname: Kang
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Jang
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Kyung-Yeol
authors.initials: KY
authors.lastname: Bae
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Il-Seon
authors.initials: IS
authors.lastname: Shin
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Cho
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000150:complications / Q000523:psychology*