title: Clinical usefulness of the two-question assessment tool for depressive symptoms in Japanese patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Depressive symptoms are highly prevalent in patients with chronic obstructive pulmonary disease (COPD) and have been associated with poor outcomes. Developing a concise questionnaire to measure depressive symptoms in COPD patients is needed in outpatient settings. We evaluated the clinical usefulness of a concise two-question instrument to assess depressive symptoms in patients with COPD.
  
  
  METHODS
  The study was conducted as a cross-sectional analysis in patients with COPD. All patients completed a self-reported questionnaire consisting of the two-question instrument, as well as a shortened version of the Center for Epidemiologic Studies Depression Scale (CESD-10) to measure depressive symptoms. Performance of the two-question instrument was evaluated using the results for CESD-10 as standard. We also measured patients' health-related quality of life using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8) to determine whether the instrument was related to SF-8.
  
  
  RESULTS
  Sensitivity of the two-question instrument in the detection of depressive symptoms was 73.3 % (95 % confidence interval [CI] 51-95.7), specificity was 73 % (95 % CI 58.7-87.3), and area under the receiver operating characteristics curve was 0.73 (95 % CI 0.59-0.87). When study patients were divided into two groups with a cutoff of 1 point on the two-question instrument, scores for all subscales of the SF-8 except "bodily pain" were significantly lower in patients with than without depressive symptoms.
  
  
  CONCLUSIONS
  This concise two-question instrument is useful as assessment of depressive symptom in patients with COPD in busy outpatient settings.
authors.affiliation: Department of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan. yasuji@fc.miyazaki-u.ac.jp
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Arimura
authors.forename: Shin
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Yanagi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Misa
authors.initials: M
authors.lastname: Takegami
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Nakazato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D059026:Diagnostic Self Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*