[A comparative validation of the scale CES-D, BDI, and HADS(d) in diagnosis of depressive disorders in general practice]

Abstract

To determine a most precise instrument for diagnostics of depression and a level of its severity, a comparative study of 3 questionnaires: Hospital Anxiety and Depression Scale (d) (HADS(d)), Beck Depression Inventory (BDI) and Center for Epidemiological Studies Depression scale (CED-D) was conducted in 148 patients (91 women, 57 men), aged 46.5 +/- 9.34 years. An analysis of sensitivity, specificity and predictive values of positive and negative results allowed to detect optimal cut off points, distinguishing depressive patients, as follows: = 18 for CES-D, = 12 for BDI, = 0.89 for HADS(d). For all scales, areas under receiver-operator characteristic (ROC) curve (0.97 +/- 0.02, 0.96 +/- 0.02 and 0.94 +/- 0.02, respectively) proved to be comparable. The optimal cut off points for distinct separation between patients with mild and severe depression were detected as = 26 for CES-D, = 20 for BDI, = 10 for HADS(d). The area under ROC curve for CES-D was higher (0.99 +/- 0.01) than those for BDI (0.86 +/- 0.04) and for HADS(d) (0.83 +/- 0.05). The data obtained reveal that the cut off points ascertained in the study reduce a chance of depression under diagnosis. All the scales could be recommended to interns for primary (screening) diagnostics of depression in routine medical care.