title: Validation of two depression screening instruments in a sleep disorders clinic.
abstract: OBJECTIVE
  Depression is a commonly diagnosed comorbidity in sleep disorder clinics. However, screening instruments for major depressive episode (MDE) have not been validated in this setting. We aimed to validate the Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory - Fast Screen (BDI-FS) with the Mini International Neuropsychiatric Interview (MINI) in patients with suspected obstructive sleep apnea (OSA).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Academic center.
  
  
  METHODS
  One hundred one new patients with a clinical suspicion of OSA, as assessed by a sleep physician.
  
  
  METHODS
  MDE, generalized anxiety disorder (GAD), and panic disorder (PD) were assessed by (1) a diagnostic interview utilizing the MINI and (2) by two self-report questionnaires: HADS and BDI-FS. A receiver operating characteristic (ROC) analysis was undertaken to assess which HADS and BDI-FS threshold yielded the highest correlation for a diagnosis of MDE and/or GAD/PD as assessed with an interview conducted using the MINI.
  
  
  RESULTS
  A HADS-Depression score ≥ 8 gave optimal sensitivity (83.1%) and specificity (83.3%) with an area under the ROC curve (AUC) 0.851 for predicting the diagnosis of MDE. A HADS-Anxiety score ≥ 11 gave an optimal sensitivity (93.1%) and specificity (84.7%) with an AUC 0.911 for predicting the diagnosis of GAD/PD. A BDI-FS threshold ≥ 6 gave optimal sensitivity (86.7%) and specificity (82.9%) with an AUC 0.897 for MDE.
  
  
  CONCLUSIONS
  The HADS and BDI-FS are accurate screening instruments with high concurrent validity for identifying the probability of a patient having MDE and-in the case of HADS-GAD and PD disorder in a sleep disorders clinic.
authors.affiliation: Alfred Hospital & Monash University, Melbourne, Australia.
authors.forename: Mandy
authors.initials: M
authors.lastname: Law
authors.affiliation: Alfred Hospital & Monash University, Melbourne, Australia.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Naughton
authors.affiliation: Baker IDI Heart & Diabetes Institute, Monash Health, Melbourne, Australia.
authors.forename: Arup
authors.initials: A
authors.lastname: Dhar
authors.affiliation: Baker IDI Heart & Diabetes Institute, Monash Health, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Barton
authors.affiliation: Alfred Hospital & Monash University, Melbourne, Australia.
authors.forename: Eli
authors.initials: E
authors.lastname: Dabscheck
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000209:etiology; D017286:Polysomnography; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D056508:Sleep Medicine Specialty / Q000379:methods*; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology
keywords: depression; obstructive sleep apnea; screening