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The validity of questionnaire measures for assessing depression after stroke

C R Nicholl

T Flannaghan

School of Psychology, University of Nottingham

M Leonard

Department of Psychiatry, Queens Medical Centre

E Van der Gucht

School of Psychology, University of Nottingham, Nottingham, UK

Objective: Depression has been reported to occur frequently after stroke. The aim of the study was to assess the validity of questionnaire measures for screening for depression after stroke.

Design: Cross-sectional correlational study between questionnaire measures of mood and psychiatric interview.

Setting: Hospital and community.

Participants: Stroke patients were recruited from hospital wards and from a randomized controlled trial of cognitive behavioural therapy.

Main measures: Beck Depression Inventory, Wakefield Depression Inventory, General Health Questionnaire 28 and Schedules for Clinical Assessment in Neuropsychiatry.

Results: Poor agreement was found between psychiatric diagnosis and questionnaire measures of mood. The sensitivity of the questionnaire measures was high, but specificity was low. No cut-off points with satisfactory sensitivity and specificity could be identified from ROC curves.

Conclusions: Although questionnaire assessments of depression provide a satisfactory screening method, specificity values are too low to provide a basis for the diagnosis of depression. Measures need to be developed with higher specificity to facilitate screening for depression after stroke.

Clinical Rehabilitation, Vol. 17, No. 8, 840-846 (2003)
DOI: 10.1191/0269215503cr687oa


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