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Sensitivity and specificity of a two-question screening tool for depression in a specialist palliative care unit

Cork University Hospital, Cork, dannann{at}eircom.net

Sandra Barry

Cork University Hospital, Cork

Brian Creedon

Marymount Hospice, St Patrick's Hospital, Cork

Carol Stone

Marymount Hospice, St Patrick's Hospital, Cork

Catherine Sweeney

Marymount Hospice, St Patrick's Hospital, Cork

Tony O' Brien

Marymount Hospice, St Patrick's Hospital, Cork

Kathleen O' Sullivan

Statistical Laboratory Unit, University College Cork

Objectives: The primary objective in this study is to determine the sensitivity and specificity of a two-item screening interview for depression versus the formal psychiatric interview, in the setting of a specialist palliative in-patient unit so that we may identify those individuals suffering from depressive disorder and therefore optimise their management in this often-complex population. Methods: A prospective sample of consecutive admissions (n = 167) consented to partake in the study, and the screening interview was asked separately to the formal psychiatric interview. Results: The two-item questionnaire, achieved a sensitivity of 90.7% (95% CI 76.9—97.0) but a lower specificity of 67.7% (95% CI 58.7—75.7). The false positive rate was 32.3% (95% CI 24.3—41.3), but the false negative rate was found to be a low 9.3% (95% CI 3.0—23.1). A subgroup analysis of individuals with a past experience of depressive illness, (n = 95), revealed that a significant number screened positive for depression by the screening test, 55.2% (16/29) compared to those with no background history of depression, 33.3% (22/66) (P = 0.045). Conclusion: The high sensitivity and low false negative rate of the two-question screening tool will aid health professionals in identifying depression in the in-patient specialist palliative care unit. Individuals, who admit to a previous experience of depressive illness, are more likely to respond positively to the two-item questionnaire than those who report no prior history of depressive illness (P = 0.045). Palliative Medicine 2007; 21: 193—198

Key Words: depression • palliative care • screening • sensitivity • specificity

Palliative Medicine, Vol. 21, No. 3, 193-198 (2007)
DOI: 10.1177/0269216307077315


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