title: Optimizing screening for depression among adults with asthma.
abstract: The Beck Depression Inventory II (BDI-II) is one of the most frequently used tools to screen for depression in patients with chronic diseases such as cardiovascular disease and asthma. However, its original cut-off score has not been validated in adult asthmatics. The present study aimed to determine the optimal BDI-II cut-off score and to verify the impact of various patient sociodemographic and clinical characteristics on performance accuracy of the BDI-II.
  
  
  
  A total of 801 adult asthmatic outpatients (mean ± SD, age 49 ± 14 years, 60% female) completed the BDI-II and a structured psychiatric interview (used as the standard referent to determine presence of major depressive disorder [MDD]). The sensitivity and specificity of the BDI-II were computed to determine the optimal cut-off score for identifying MDD. The optimal cut-off scores were also verified across covariate subgroups (e.g., sex, age, smoking status, asthma control levels).
  
  
  
  According to the structured psychiatric interview, 108 (13%) patients had current MDD. The overall optimal BDI-II cut-off score was 12 (sensitivity = 85%, specificity = 79%). However, subgroup analyses revealed that this score could range from 11 to 15 depending on the characteristics of the individual.
  
  
  
  Results suggest that the BDI-II is an appropriate screening tool for MDD in asthma populations. However, the cut-off score is influenced by the sociodemographic and clinical characteristics of patients. These findings highlight the importance of validating generic questionnaires for depression in specific populations in order to improve the accuracy of their usage.
authors.affiliation: a Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.|b Department of Psychology , Université du Québec à Montréal (UQAM) , Montréal , Quebec , Canada.|c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.
authors.forename: Annik
authors.initials: A
authors.lastname: Plourde
authors.affiliation: c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.|e Department of Preventive and Social Medicine , Faculty of Medicine, University of Montréal , Montréal , Quebec , Canada.|f Department of Psychoeducation and Psychology , Université du Québec en Outaouais (UQO) , Quebec , Canada.
authors.forename: Gregory
authors.initials: G
authors.lastname: Moullec
authors.affiliation: a Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.|c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.|d Department of Exercise Science , Concordia University , Montréal , Quebec , Canada.
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.affiliation: c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.|e Department of Preventive and Social Medicine , Faculty of Medicine, University of Montréal , Montréal , Quebec , Canada.|g Technology Assessment Unit, McGill University Health Center , Montréal , Quebec , Canada.
authors.forename: Eva
authors.initials: E
authors.lastname: Suarthana
authors.affiliation: a Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.|b Department of Psychology , Université du Québec à Montréal (UQAM) , Montréal , Quebec , Canada.|c Research Centre, Hôpital du Sacré-Cœur de Montréal , Montréal , Quebec , Canada.
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D015992:Body Mass Index; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors
keywords: Beck Depression Inventory II; Depressive symptoms; diagnostic accuracy; sensitivity; specificity