title: Tablet-based screening of depressive symptoms in quito, ecuador: efficiency in primary care.
abstract: Depression is a frequent yet overlooked occurrence in primary health care clinics worldwide. Depression and related health screening instruments are available but are rarely used consistently. The availability of technologically based instruments in the assessments offers novel approaches for gathering, storing, and assessing data that includes self-reported symptom severity from the patients themselves as well as clinician recorded information. In a suburban primary health care clinic in Quito, Ecuador, we tested the feasibility and utility of computer tablet-based assessments to evaluate clinic attendees for depression symptoms with the goal of developing effective screening and monitoring tools in the primary care clinics. We assessed individuals using the 9-item Patient Health Questionnaire, the Quick Inventory of Depressive Symptoms-Self-Report, the 12-item General Health Questionnaire, the Clinical Global Impression Severity, and a DSM-IV checklist of symptoms. We found that 20% of individuals had a PHQ9 of 8 or greater. There was good correlation between the symptom severity assessments. We conclude that the tablet-based PHQ9 is an excellent and efficient method of screening for depression in attendees at primary health care clinics and that one in five people should be assessed further for depressive illness and possible intervention.
authors.affiliation: Universidad San Francisco de Quito, 17-1200-841 Quito, Ecuador.
authors.forename: Michelle
authors.initials: M
authors.lastname: Grunauer
authors.affiliation: University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schrock
authors.affiliation: Universidad San Francisco de Quito, 17-1200-841 Quito, Ecuador.
authors.forename: Eric
authors.identifier: 0000-0001-9983-0474
authors.initials: E
authors.lastname: Fabara
authors.affiliation: Universidad San Francisco de Quito, 17-1200-841 Quito, Ecuador.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Jimenez
authors.affiliation: Universidad San Francisco de Quito, 17-1200-841 Quito, Ecuador ; University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Aimee
authors.initials: A
authors.lastname: Miller
authors.affiliation: University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Zongshan
authors.initials: Z
authors.lastname: Lai
authors.affiliation: University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Kilbourne
authors.affiliation: University of Michigan, Ann Arbor, MI 48109, USA ; University of Michigan Depression Center, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
authors.forename: Melvin G
authors.initials: MG
authors.lastname: McInnis