Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-25T00:16:43.542Z Has data issue: false hasContentIssue false

Is it useful to ask “Está deprimido?” (“Are you depressed?”) to terminally-ill Portuguese patients? Results from outpatient research

Published online by Cambridge University Press:  20 May 2015

Miguel Julião*
Affiliation:
Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal; and Center for Evidence Based Medicine, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal
Baltazar Nunes
Affiliation:
Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
Maria Ana Sobral
Affiliation:
Family Medicine Trainee at USF AlphaMouro, Palliative Care MSc Student at Faculty of Medicine of the University of Lisbon, Lisboa, Portugal
Daniela Dias
Affiliation:
Palliative Care MSc Student at Faculty of Medicine of the University of Lisbon, Lisboa, Portugal; and Unidade de Medicina Paliativa e de Hospitalização Domiciliária do Centro Clínico Champalimaud - Champalimaud Centre for the Unknown, Lisboa, Portugal
Inês Inocêncio
Affiliation:
Palliative Care MSc Student at Faculty of Medicine of the University of Lisbon, Lisboa, Portugal; and Unidade de Medicina Paliativa e de Hospitalização Domiciliária do Centro Clínico Champalimaud - Champalimaud Centre for the Unknown, Lisboa, Portugal
António Barbosa
Affiliation:
Center of Bioethics, Faculty of Medicine of the University of Lisbon, Lisboa, Portugal; and Department of Psychiatry, Hospital de Santa Maria, Lisboa, Portugal
*
Address correspondence and reprint requests to: Miguel Julião, Center of Bioethics – Av. Prof. Egas Moniz. 1649-028 Lisboa, Portugal. E-mail: migueljuliao@gmail.com

Abstract

Objectives:

Depression is a serious psychological problem in the palliative care setting. Brief screening tools for depression are lacking and need to be brief and acceptable. This study aimed to identify the properties of the single Portuguese question “Está deprimido?” (“Are you depressed?”) to screen for depression.

Methods:

Retrospective study from 100 patient's medical records identifying the answers on the single Portuguese question for depression “Está deprimido?” (“Are you depressed?”) and the HADS depression sub-scale, using a score ≥11 on the latter as the gold standard for clinically significant depressive symptoms. Sensitivity, specificity, positive predictive and negative values were calculated.

Results:

Response rate for the single Portuguese question for depression was 100%. Prevalence of depression symptoms (HADS-d ≥ 11) was 43%. To the question “Está deprimido?” 60 patients responded “yes.” Sixteen patients who replied “no” to the single question had clinically significant depressive symptoms based on the HADS depression sub-scale. The single tool had 65.2% sensitivity, 49.2% specificity and 50.0% and 64.4% of positive predictive and negative values, respectively.

Significance of results:

In this first preliminary retrospective Portuguese study, the single question for depression has shown poor screening properties. Future research in larger and mixed patientś samples of Portuguese terminally ill is necessary to find more accurate and robust properties of this brief tool.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bayés, R., Limonero, J.T., Barreto, P. & Comas, M.D. (1997). A way to screen for suffering in palliative care. Journal of Palliative Care, 13, 2226.CrossRefGoogle ScholarPubMed
Block, S.D. (2000). Assessing and managing depression in the terminally ill patient. ACP-ASIM End-of-Life Care Consensus Panel. American College of Physicians – American Society of Internal Medicine. Annals of Internal Medicine, 132, 209–18.CrossRefGoogle ScholarPubMed
Chochinov, H.M., Wilson, K.G., Enns, M. & Lander, S. (1997). “Are you depressed?” Screening for depression in the terminally ill. American Journal of Psychiatry, 154, 674676.Google ScholarPubMed
Hotopf, M., Chidgey, J., Addington-Hall, J. & Ly, K.L. (2002). Depression in advanced disease: A systematic review Part 1. Prevalence and case finding. Palliative Medicine, 16, 8197Google ScholarPubMed
Julião, M., Oliveira, F., Nunes, B. & Barbosa, A. (2013). Time and life perception in the terminally ill: Its utility in screening for depression. Journal of Palliative Medicine, 16:14331437.CrossRefGoogle ScholarPubMed
Julião, M., Barbosa, A., Oliveira, F., Nunes, B. & Vaz Carneiro, A. (2013). Efficacy of dignity therapy for depression and anxiety in terminally ill patients: early results of a randomized controlled trial. Palliative & Support Care, 11, 481489.CrossRefGoogle ScholarPubMed
Julião, M., Oliveira, F., Nunes, B., Vaz Carneiro, A. & Barbosa, A. (2014). Efficacy of dignity therapy on depression and anxiety in Portuguese terminally ill patients: A phase II randomized controlled trial. Journal of Palliative Medicine, 17, 688695.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M., Dennis, M., Taylor, F. & Baker, I. (2003). Is asking patients in palliative care, “are you depressed?” Appropriate? Prospective study. British Medical Journal, 16, 372373.CrossRefGoogle Scholar
Mahoney, J., Drinka, T.J.K., Abler, R., Gunter-Hunt, G., Matthews, C., Gravenstein, S. & Carnes, M. (1994). Screening for depression: single question versus GDS. Journal of American Geriatrics Society, 42,10061008.Google ScholarPubMed
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R. & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health & Medicine, 12, 225235Google Scholar