Magazine article Clinical Psychiatry News

Rapid Depression Screen Shows Promise in ED

Magazine article Clinical Psychiatry News

Rapid Depression Screen Shows Promise in ED

Article excerpt

BOSTON -- The use of simple screening instruments in the emergency department setting could aid in the recognition of mental health disorders, a study has shown.

And subsequent referral to mental health services of patients who screen positive would probably have a significant public health impact, as many of them might otherwise go undiagnosed and untreated, Edwin Boudreaux, Ph.D., said in a presentation at the annual meeting of the Society for Behavioral Medicine.

In a prospective, multicenter trial, 28% of consecutive adult patients presenting to an urban emergency department during a 3-week period screened positive for depression, and 7% screened positive for bipolar disorder using brief mood disorder screening instruments, reported Dr. Boudreaux of Cooper Hospital and the Robert Wood Johnson Medical School in Camden (N.J).

The results of the brief screens were then measured against those of validated screening tools to assess the utility of the screens.

The cross-sectional study of patients 18 years or older excluded those who were severely ill or who had altered mental status upon presentation to the emergency department.

The initial interview of patients meeting study criteria included the Mood Disorder Questionnaire (MDQ) to screen for bipolar disorder and a depression screener comprising the two questions recommended by the U.S. Preventive Health Services Task Force: Over the past few weeks, have you felt down, depressed, or hopeless? Over the past 2 weeks, have you felt little interest or pleasure in doing things?

To test the validity of the results of the initial screen, investigators contacted all of the patients 3-5 days postvisit and rescreened them

using the self-report Center for Epidemiologic Studies Depression (CES-D) scale and the Bipolar Spectrum Diagnostic Scale (BSDS).

Of the 243 patients enrolled, 69 screened positive for depression and 18 screened positive for bipolar disorder based on emergency department interviews. …

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