Mood disorders are a global health issue. National guidance for their detection and management have been published in the US and in Europe. Despite this, the rate at which depression is recognized and managed in primary and secondary care settings remains low and suggests that many clinicians are still unsure how to screen people for mood disorders. Against the backdrop of this problem, the editors of this volume have designed a book with a dynamic two-fold purpose: to provide an evidence-based overview of screening methods for mood disorders, and to synthesize the evidence into a practical guide for clinicians in a variety of settings--from cardiologists and oncologists, to primary care physicians and neurologists, among others. The volume considers all important aspects of depression screening, from the overview of specific scales, to considerations of technological approaches to screening, and to the examination of screening with neurological disorders, prenatal care, cardiovascular conditions, and diabetes and cancer care, among others. This book is sure to capture the attention of any clinician with a stake in depression screening.
Author(s): Alex J. Mitchell MRCPsych, James C. Coyne PhD
Edition: 1
Year: 2009
Language: English
Pages: 416
Contents......Page 6
List of Contributors......Page 12
Preface......Page 16
What is Meant by Depression?......Page 22
Value and Validity of the Syndrome Concept......Page 26
Diagnostic Checklists (including DSM and ICD)......Page 29
Unstructured (Unassisted) Clinician Diagnosis......Page 34
Structured and Semi-Structured Assisted Diagnostic Interviews......Page 38
Conclusion......Page 41
References......Page 43
Background......Page 48
The Classic Severity Scales (1960–1980)......Page 55
The New Severity Scales (1981–2008)......Page 58
The Future of Screening Scales......Page 63
References......Page 70
Introduction to the Problem of Over- and Under-Detection......Page 76
Predictors of Detection......Page 81
Patient and Clinician Influences on Detection......Page 85
Illness-Related Influences on Detection......Page 90
Conclusions......Page 93
References......Page 94
Introduction......Page 102
The Rasch Model and Other Item Response Models......Page 105
Conclusion......Page 114
References......Page 115
How Do Clinicians Make a Diagnosis?......Page 118
Scientific Aspects of Diagnostic Accuracy......Page 122
Clinical Aspects of Diagnostic Accuracy......Page 124
Testing Screening via Implementation Studies......Page 128
References......Page 130
Introduction......Page 132
Research on Clinical Judgment......Page 133
The Limits of Screening......Page 138
References......Page 139
The Case for Screening......Page 142
New and Additional Evidence Relating to Enhanced Care......Page 147
Is Screening a Necessary Intervention to Improve the Quality and Outcome of Care?......Page 148
To Screen or Not to Screen?......Page 155
References......Page 156
8. Technological Approaches to Screening and Case Finding for Depression......Page 162
Technological Methods of Screening for Depression......Page 163
Ten Issues When Developing Computerized Screening for Depression......Page 166
Examples of Implementation of Computerized Screening for Depression......Page 169
Discussion......Page 172
References......Page 173
Introduction......Page 180
Epidemiology of Depression in Primary Care......Page 181
Is Screening for Depression in Primary Care Worthwhile?......Page 184
Which Screening Tool Should Be Used?......Page 188
Implementing Screening in Primary Care......Page 197
What Developments Are on the Horizon?......Page 202
References......Page 204
An Introductory Logic......Page 210
Depression in the Medically Ill......Page 211
“False-Positive” Depression Reflecting Confounding by Physical Symptoms Associated with Medical Illness......Page 212
Screening Measures Used to Assess Depression in the Medically Ill......Page 213
Discussion......Page 217
References......Page 218
Overview of Depression in Physical Disease......Page 222
Defining Somatic Symptoms......Page 224
Diagnostic Accuracy of Somatic Symptoms in Depression......Page 228
Evidence For and Against Somatic Symptoms when Diagnosing Comorbid Depression......Page 230
Implications for Screening......Page 236
References......Page 255
12. Screening for Depression in Neurologic Disorders......Page 260
Depression in Stroke......Page 261
Depression in Multiple Sclerosis......Page 265
Depression in Epilepsy......Page 268
Depression in Parkinson’s Disease......Page 274
References......Page 277
Prevalence of Depression in Cancer Care......Page 284
Screening Methods for Depression......Page 285
Screening for Depression in Oncology......Page 286
Implementing Screening Programs in Oncology Settings......Page 295
Special Issues in Screening Cancer Patients......Page 311
Summary, Integration, Future Directions......Page 312
Acknowledgments......Page 313
References......Page 314
Introduction: Perinatal Screening in Context......Page 318
Why Screen, and What Are We Screening For?......Page 320
Screening Practices in Perinatal Settings......Page 322
Screening Guidelines and Recommendations......Page 323
Evidence-Based Comparison of Screening Methods......Page 324
Implementation in Practice: Does Screening Make any Real-World Difference?......Page 329
Service Delivery and Treatment Implications......Page 330
Summary and Key Recommendations......Page 332
References......Page 333
15. Screening in Cardiovascular Care......Page 336
Depression in Cardiovascular Disease......Page 337
The Prevalence of Depression in Cardiovascular Disease......Page 338
Screening Instruments for Depression in Cardiovascular Care......Page 339
Recommendations for Evaluation and Treatment of Patients in Cardiovascular Care......Page 345
Conclusions......Page 347
References......Page 348
16. Screening in Diabetes Care: Detecting and Managing Depression in Diabetes......Page 354
Depression in Diabetes is a Major Health Problem......Page 356
Screening Tests......Page 359
Treatment Options......Page 362
Screening Program......Page 363
Conclusions for Clinical Practice......Page 364
References......Page 365
17. Commentary and Integration: Is it Time to Routinely Screen for Depression in Clinical Practice?......Page 368
Integration: Deflating the Puffer Phenomenon and Making the Case Against Screening......Page 383
References......Page 385
Appendix......Page 390
B......Page 404
C......Page 405
D......Page 406
E......Page 407
M......Page 408
N......Page 409
P......Page 410
R......Page 411
S......Page 412
U......Page 413
Z......Page 414
