title: Diagnostic accuracy for major depression in multiple sclerosis using self-report questionnaires.
abstract: OBJECTIVE
  Multiple sclerosis and major depressive disorder frequently co-occur but depression often remains undiagnosed in this population. Self-rated depression questionnaires are a good option where clinician-based standardized diagnostics are not feasible. However, there is a paucity of data on diagnostic accuracy of self-report measures for depression in multiple sclerosis (MS). Moreover, head-to-head comparisons of common questionnaires are largely lacking. This could be particularly relevant for high-risk patients with depressive symptoms. Here, we compare the diagnostic accuracy of the Beck Depression Inventory (BDI) and 30-item version of the Inventory of Depressive Symptomatology Self-Rated (IDS-SR30) for major depressive disorder (MSS) against diagnosis by a structured clinical interview.
  
  
  METHODS
  Patients reporting depressive symptoms completed the BDI, the IDS-SR30 and underwent diagnostic assessment (Mini International Neuropsychiatric Interview, M.I.N.I.). Receiver-Operating Characteristic analyses were performed, providing error estimates and false-positive/negative rates of suggested thresholds.
  
  
  RESULTS
  Data from n = 31 MS patients were available. BDI and IDS-SR30 total score were significantly correlated (r = 0.82). The IDS-SR30total score, cognitive subscore, and BDI showed excellent to good accuracy (area under the curve (AUC) 0.86, 0.91, and 0.85, respectively).
  
  
  CONCLUSIONS
  Both the IDS-SR30 and the BDI are useful to quantify depressive symptoms showing good sensitivity and specificity. The IDS-SR30 cognitive subscale may be useful as a screening tool and to quantify affective/cognitive depressive symptomatology.
authors.affiliation: Department of Health Psychology, King's College London SE1 9RT, London, UK ; Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Fischer
authors.affiliation: Department of Pharmaceutical Chemistry, University of California San Francisco San Francisco, California, 94158.
authors.forename: Marcus
authors.initials: M
authors.lastname: Fischer
authors.affiliation: Structural Studies Division, MRC Laboratory of Molecular Biology Cambridge, CB2 0QH, UK.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Nicholls
authors.affiliation: Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lau
authors.affiliation: Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Poettgen
authors.affiliation: Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany.
authors.forename: Kostas
authors.initials: K
authors.lastname: Patas
authors.affiliation: Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Neurology, University Medical Center Hamburg-Eppendorf Hamburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Heesen
authors.affiliation: Center for Molecular Neurobiology, Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf Hamburg, Germany ; Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin (CBF), Charité Universitätsmedizin Berlin, Germany.
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Gold
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis; D003865:Major Depressive Disorder / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: Major depressive disorder; multiple sclerosis; self report; sensitivity and specificity; validation studies