TY - JOUR
T1 - The prevalence of depression and the accuracy of depression screening tools in migraine patients
AU - Amoozegar, Farnaz
AU - Patten, Scott B.
AU - Becker, Werner J.
AU - Bulloch, Andrew G.M.
AU - Fiest, Kirsten M.
AU - Davenport, W. Jeptha
AU - Carroll, Christopher R.
AU - Jette, Nathalie
N1 - Funding Information:
This study was funded by the University of Calgary Cumming School of Medicine, Alberta Health Services, and the Hotchkiss Brain Institute. S.B. Patten is supported by a Senior Health Scholar award from Alberta Innovates Health Solutions (AI-HS). N. Jette holds a Canada Research Chair (Tier 2) in Neurological Health Services Research and held an AI-HS Population Health Investigator Award during completion of this study.
Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/9
Y1 - 2017/9
N2 - Objectives Migraine and depression are common comorbid conditions. The purpose of this study was to assess how well the Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS) perform as depression screening tools in patients with migraine. Methods Three hundred consecutive migraine patients were recruited from a large headache center. The PHQ-9 and HADS were self-administered and validated against the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–IV, a gold standard for the diagnosis of depression. Sensitivity, specificity, positive predictive value, negative predictive value and receiver-operator characteristic curves were calculated for the PHQ-9 and HADS. Results At the traditional cut-point of 10, the PHQ-9 demonstrated 82.0% sensitivity and 79.9% specificity. At a cut-point of 8, the HADS demonstrated 86.5% sensitivity and specificity. The PHQ-9 algorithm performed poorly (53.8% sensitivity, 94.9% specificity). The point prevalence of depression in this study was 25.0% (95% CI 19.0–31.0), and 17.0% of patients had untreated depression. Conclusions In this study, the PHQ-9 and HADS performed well in migraine patients attending a headache clinic, but optimal cut-points to screen for depression vary depending on the goals of the assessment. Also, migraine patients attending a headache clinic have a high prevalence of depression and many are inadequately treated. Future studies are needed to confirm these findings and to evaluate the impact of depression screening.
AB - Objectives Migraine and depression are common comorbid conditions. The purpose of this study was to assess how well the Patient Health Questionnaire (PHQ-9) and the Hospital Anxiety and Depression Scale (HADS) perform as depression screening tools in patients with migraine. Methods Three hundred consecutive migraine patients were recruited from a large headache center. The PHQ-9 and HADS were self-administered and validated against the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders–IV, a gold standard for the diagnosis of depression. Sensitivity, specificity, positive predictive value, negative predictive value and receiver-operator characteristic curves were calculated for the PHQ-9 and HADS. Results At the traditional cut-point of 10, the PHQ-9 demonstrated 82.0% sensitivity and 79.9% specificity. At a cut-point of 8, the HADS demonstrated 86.5% sensitivity and specificity. The PHQ-9 algorithm performed poorly (53.8% sensitivity, 94.9% specificity). The point prevalence of depression in this study was 25.0% (95% CI 19.0–31.0), and 17.0% of patients had untreated depression. Conclusions In this study, the PHQ-9 and HADS performed well in migraine patients attending a headache clinic, but optimal cut-points to screen for depression vary depending on the goals of the assessment. Also, migraine patients attending a headache clinic have a high prevalence of depression and many are inadequately treated. Future studies are needed to confirm these findings and to evaluate the impact of depression screening.
KW - Depression
KW - Migraine
KW - Prevalence
KW - Screening
KW - Sensitivity
KW - Specificity
UR - http://www.scopus.com/inward/record.url?scp=85021430405&partnerID=8YFLogxK
U2 - 10.1016/j.genhosppsych.2017.06.006
DO - 10.1016/j.genhosppsych.2017.06.006
M3 - Article
C2 - 28917391
AN - SCOPUS:85021430405
SN - 0163-8343
VL - 48
SP - 25
EP - 31
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
ER -