TY - JOUR
KW - Aged
KW - Depression/diagnosis
KW - Depressive Disorder/diagnosis
KW - Family Practice
KW - Humans
KW - Middle Aged
KW - Outcome Assessment (Health Care)
KW - Patient-Centered Care
KW - Pilot Projects
KW - Predictive Value of Tests
KW - Primary Health Care
KW - Psychiatric Status Rating Scales
KW - Questionnaires
KW - Sensitivity and Specificity
KW - Sweden
AU - M. Magnil
AU - R. Gunnarsson
AU - C. Bjorkelund
A1 - 
AB - OBJECTIVE: Using validated screening instruments to detect depressive symptoms in the elderly has been recommended. The aim of this study was to compare a patient-centred consultation model with the PRIME-MD screening questionnaire, using the MADRS-S as reference for detecting depressive symptoms in an elderly primary care population. DESIGN: Comparative study. SETTING: Primary care, Sweden. SUBJECTS: During an 11-month period 302 consecutive patients aged 60 and over attending a primary care centre were screened with the PRIME-MD and the Montgomery-Asberg Depression Rating Scale-Self-rated version (MADRS-S) instrument. The results were unknown to the GPs who used a structured, patient-centred consultation model comprising seven open-ended "key questions". MAIN OUTCOME MEASURES: Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated for the PRIME-MD screening questionnaire and the patient-centred consultation model using MADRS-S as reference for possible depression at two cut-off levels with 15% prevalence. Results. Sensitivity was lower for the consultation model than the PRIME-MD screening questionnaire: 78% and 98%, respectively. The GPs failed to identify every fifth patient using the lower cut-off (MADRS-S>/=13) but the number of required diagnostic interviews decreased by almost 50%: 85 versus 162, respectively. PPV was 43% and 28%, respectively. Both instruments showed high sensitivity (93%) using the higher cut-off (MADRS-S>/=20) and had high NPV: 95% and 99%, respectively. CONCLUSIONS: The findings suggest that the consultation screening procedure might be as useful in everyday practice as the PRIME-MD screening questionnaire. Both screening procedures may also be useful for ruling out depressive symptoms.
BT - Scandinavian journal of primary health care
C5 - General Literature
CP - 1
CY - England
DO - 10.3109/02813432.2011.554011
IS - 1
JF - Scandinavian journal of primary health care
N2 - OBJECTIVE: Using validated screening instruments to detect depressive symptoms in the elderly has been recommended. The aim of this study was to compare a patient-centred consultation model with the PRIME-MD screening questionnaire, using the MADRS-S as reference for detecting depressive symptoms in an elderly primary care population. DESIGN: Comparative study. SETTING: Primary care, Sweden. SUBJECTS: During an 11-month period 302 consecutive patients aged 60 and over attending a primary care centre were screened with the PRIME-MD and the Montgomery-Asberg Depression Rating Scale-Self-rated version (MADRS-S) instrument. The results were unknown to the GPs who used a structured, patient-centred consultation model comprising seven open-ended "key questions". MAIN OUTCOME MEASURES: Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated for the PRIME-MD screening questionnaire and the patient-centred consultation model using MADRS-S as reference for possible depression at two cut-off levels with 15% prevalence. Results. Sensitivity was lower for the consultation model than the PRIME-MD screening questionnaire: 78% and 98%, respectively. The GPs failed to identify every fifth patient using the lower cut-off (MADRS-S>/=13) but the number of required diagnostic interviews decreased by almost 50%: 85 versus 162, respectively. PPV was 43% and 28%, respectively. Both instruments showed high sensitivity (93%) using the higher cut-off (MADRS-S>/=20) and had high NPV: 95% and 99%, respectively. CONCLUSIONS: The findings suggest that the consultation screening procedure might be as useful in everyday practice as the PRIME-MD screening questionnaire. Both screening procedures may also be useful for ruling out depressive symptoms.
PP - England
PY - 2011
SN - 1502-7724; 0281-3432
SP - 51
EP - 56
EP - 
T1 - Using patient-centred consultation when screening for depression in elderly patients: a comparative pilot study
T2 - Scandinavian journal of primary health care
TI - Using patient-centred consultation when screening for depression in elderly patients: a comparative pilot study
U1 - General Literature
U2 - 21323497
U3 - 10.3109/02813432.2011.554011
VL - 29
VO - 1502-7724; 0281-3432
Y1 - 2011
ER -