New Research Summary: Screening for Depression in People with MS

What was this research about?

Depression is a common problem among people with multiple sclerosis (MS) that can lead to poor health and quality of life. People with MS tend to be under-treated for depression. In order to provide proper treatment, we need an accurate way to find out if someone is experiencing low mood.  In clinics, we screen for depression by looking at responses to questions like: How often have you been bothered by feeling down? There are many questionnaires that can be used to screen for depression. The best questionnaire correctly identifies people with depression without flagging those who do not need treatment for depression. In this research, we compared six depression questionnaires to a standard clinical interview commonly used to diagnose depression.  We wanted to see which questionnaire was the best indicator that someone living with MS was feeling depressed and should be referred for evaluation or treatment.

What did the researchers do?

We enrolled about 160 people with MS with differing levels of depression. The six depression questionnaires were mailed to participants. Then, after completing the surveys, the participants completed a clinical interview by phone with the research assistant. These interviews were audio-recorded, and a therapist with depression expertise made a diagnosis based on the recorded interviews. We compared the survey answers with the expert diagnoses to see which questionnaire most closely matched the interview diagnosis.

What did the researchers find?

About 30% of the participants were found have depression by the clinical interview. None of the questionnaires stood out as clearly the best. All questionnaires flagged too many of the participants who were not depressed as having depression.  While all of the questionnaires over-diagnosed depression in people with MS, the Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Patient Health Questionnaire-9 (PHQ-9) overlapped most with the therapist diagnoses.

How can you use this research?

Current depression questionnaires are not as accurate as they could be in identifying people with MS who experience depression. A new screening tool may need to be developed to improve accuracy of depression screening, perhaps by combining questions across some of the existing tools.

Things you should know:

If you suspect that you or a loved one may be feeling depressed, take a look at our fact sheet on How to Cope with Depression.

Original Research Article:

Amtmann D, Bamer AM, Johnson KL, Ehde DM, Beier ML, Elzea JL, Bombardier CH. A comparison of multiple patient reported outcome measures in identifying major depressive disorder in people with multiple sclerosis. J Psychosom Res. 2015; 79:550-7.