☆ 4.6 Article

Evaluating the Psychometric Properties and Responsiveness to Change of 3 Depression Measures in a Sample of Persons With Traumatic Spinal Cord Injury and Major Depressive Disorder

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2016)

Journal

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION

Volume 97, Issue 6, Pages 929-937

Publisher

W B SAUNDERS CO-ELSEVIER INC

DOI: 10.1016/j.apmr.2016.01.017

Keywords

Depression; Outcome assessment (health care); Psychometrics; Rehabilitation; Spinal cord injuries

Funding

Department of Education, National Institute on Disability and Rehabilitation Research [H133A060107, H133N110009]
Pfizer Pharmaceuticals [0600B1-4439]

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Abstract

Objectives: To compare the measurement properties and responsiveness to change of the Patient Health Questionnaire-9 (PHQ-9), the Hopkins Symptom Checklist-20 (HSCL-20), and the Hamilton Depression Rating Scale (HAM-D) in people with spinal cord injury (SCI) diagnosed with major depressive disorder (MDD). Design: Secondary analysis of depression symptoms measured at 6 occasions over 12 weeks as part of a randomized controlled trial of venlafaxine XR for MDD in persons with SCI. Setting: Outpatient and community settings. Participants: Individuals (N=133) consented and completed the drug trial. Eligibility criteria were age at least 18 years, traumatic SCI, and diagnosis of MDD. Interventions: Venlafaxine XR. Main Outcome Measures: Patients completed the PHQ-9 and the HSCL-20 depression scales; clinical investigators completed the HAM-D and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) Dissociative Disorders, which was used as a diagnostic criterion measure. Results: All 3 instruments were improved with rating scale analysis. The HSCL-20 and the HAM-D contained items that misfit the underlying construct and that correlated weakly with the total scores. Removing these items improved the internal consistency, with floor effects increasing slightly. The HAM-D correlated most strongly with Structured Clinical Interview for DSM-IV Dissociative Disorders diagnoses. Improvement in depression was similar on all outcome measures in both treatment and control groups. Conclusions: The psychometric properties of the revised depression instruments are more than adequate for routine use in adults with SCI and are responsive to clinical improvement. The PHQ-9 is the simplest instrument with measurement properties as good as or better than those of the other instruments and required the fewest modifications. (C) 2016 by the American Congress of Rehabilitation Medicine

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Anxiety in Response to Sustaining Spinal Cord Injuries and Disorders: When Should Clinicians Be Concerned?

Jane Duff, Lucy C. Grant, Jennifer Coker, Kimberley R. Monden

Summary: This study aims to recommend a cut-off score for the brief 2-item Generalized Anxiety Disorder (GAD-2) measure for individuals with spinal cord injuries/disorders (PwSCI/D) and estimate the occurrence of anxiety within this population using the full 7-item Generalized Anxiety Disorder (GAD-7) measure. The findings show that anxiety occurrence is elevated among PwSCI/D compared to the general population, and it is recommended to use a cut-off score of >= 2 for the GAD-2 and a threshold of >= 8 for the GAD-7 to ensure the maximum number of individuals with anxiety symptoms are recognized.

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2023)