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Two single-item questions helped identify depression in patients with LBP
Researchers recently compared the effect of two single-item questions with two longer questionnaires to identify depression and anxiety in patients with chronic low back pain.
“The results showed that the single-item screening questions were sensitive for depression but less sensitive for anxiety. They both performed similar to 2 widely used and validated questionnaires; the depression question had very high sensitivity but less specificity, whereas the anxiety question had similar or better sensitivity and specificity than the 2 longer questionnaires. In both cases, however, follow-up assessments would be needed to confirm a diagnosis of either depression or anxiety,” Silje Endresen Reme, PhD, and colleagues wrote in the study.
They included 564 patients in the study (50% women) with a mean age of 45 years old. The participants had back pain for 11 years, according to the study.
The study involved administering single-item questions for depression and anxiety from the Subjective Health Complaint Inventory, as well as two longer questionnaires — the Hospital Anxiety and Depression Scale and Hopkins Symptom Checklist-25, and comparing their findings them with Mini-International Neuropsychiatric Interview results. The latter is considered the “gold standard,” according to Reme and colleagues.
“In research, the depression screening question could replace longer screening instruments to identify potentially depressed patients, particularly in cases where length is a concern. Although the single anxiety question was less sensitive than the depression question, and therefore may be insufficient as a screening tool in clinical practice, it still showed similar or better discriminating abilities than the 2 longer questionnaires. We thus suggest that the anxiety question could be suitable for epidemiological studies, to replace longer questionnaires, whereas the depression question could be suitable as a screening tool in clinical practice to identify patients with a possible depressive disorder,” Reme and colleagues wrote in the study.
Disclosure: Grant funds from The Research Council of Norway were received in support of this work.
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Reme S. Spine. 2014;doi:10.1097/BRS.0000000000000214