AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #380 - Screening for depression in HIV-infected patients using the hospital anxiety and depression scale and the Beck Depression Iinventory
Authors: Presenting Author: Dr Jordi Blanch - Hospital Clinic Barcelona
Additional Authors: Dr Ricard Navines, Mrs Araceli Rousaud, Dr Esteban Martinez,
Aim: The aim of this study was to compare the Spanish version of the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), the cognitive-affective subscale of the Beck Depression Inventory (BDI-12) and the total BDI scale (BDI-21),as screening tools for major depression in a Spanish sample of HIV infected patients, assessing their sensitivity, specificity and predictive values.
Method / Issue: Patients referred to our Consultation-Liaison Unit from the Infectious diseases department were interviewed using the Structured Interview for DSM-IV and completed both the BDI and HADS scales. Results of the Receiver Operating Characteristic (ROC) analysis was used to construct individual ROC curves utilizing the entire BDI and the subsets of the cognitive-affective items and the HADS-D scale calculating the area under the curve (AUC) of each scale.
Results / Comments: Seventy-six (59% men; 41% women) HIV-infected patients with a mean age of 35 years were assessed. The prevalence of depression was: 34.7% using DSM-IV criteria; 85.5% using the BDI-21 with a cutoff of 15, 64% using the cognitive-affective subscale of the BDI-12 with a cutoff of 10; and 41.3% using the HADS-D with a cutoff of 10 (HADS-10). For the HADS-D (>10) the area under the ROC curve for major depression was 0.75 (95% CI: 0.64-0.87), sensitivity 74.1%, specificity 77.1%, positive predictive value (PPV) 64.5%, and negative predictive value (NPV) 84.1%. For the BDI-12 the area under the ROC curve for major depression was 0.66 (95% CI: 0.54-0.79), sensitivity 85.2%, specificity 47.9%, PPV 47.9%, and NPV 85.2%. For the BDI-21 the area under the ROC curve for major depression was 0.61 (95% CI: 0.49-0.74), sensitivity 89, specificity 22.9%, PPV 42.2%, and NPV 87.1%.
Discussion: Results of the present study suggest that the HADS-D scale would represent the best choice for screening depression in HIV-infected patients, followed by cognitive-affective BDI subscale and the total BDI scale.
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