Studies of Diagnostic Accuracy of Spanish Language Depression-Screening Instruments in Non-US Primary Care Settings
| First Author, Publication Year (Language) | Sample Characteristics, Recruitment Setting (Country) | Reference Standard, Depressive Disorder (Prevalence) | Screening Instrument (No. of Items) | Score Range | Cut Pointa (≥) | Sensitivity % (95% CI) | Specificity % (95% CI) | AUC (95%CI) | Quality Rating |
|---|---|---|---|---|---|---|---|---|---|
| AUC = area under curve; EPDS = Edinburgh Postnatal Depression Scale; GDS = Geriatric Depression Scale; GMS = Geriatric Mental State Schedule; MADRS = Montgomery-Asberg Depression Rating Scale; MHAS = Mexican Health and Age Study; NR = not reported; PHQ-9 = Patient Health Questionnaire; PRIME-MD-9=Primary Care Evaluation of Mental Disorders; SCAN = Schedule for Clinical Assessment in Neuropsychiatry; SCID = Structured Clinical Interview for DSM-IV; SDS = Zung Self-rating Depression Scale. | |||||||||
| a When sensitivity and specificity data were presented for multiple cut points, standard cut points (as reported by individual study authors) are presented. Where possible, we also include other cut points as needed to permit between-study comparisons for the same screening instrument. | |||||||||
| b Depression severity (ie, major vs minor) not specified in article. | |||||||||
| Aguilar-Navarro, 2007 (Spanish)32 | 199 Patients ages >64 y; outpatient geriatric clinic (Mexico) | SCID Depressionb (56%) | MHAS (9) | 0–9 | 5 | 81 (72–88) | 69 (58–78) | 0.79 (0.73–0.86) | Fair |
| Vega-Dienstmaier, 2002 (Spanish)33 | 321 Postpartum women (Peru) | SCID Major depression (7%) | EPDS (10) | 0–30 | 13 | 89 (67–99) | 72 (67–77) | NR | Fair |
| Wulsin, 2002 (English)34 | 34 Mothers of young children; primary care clinics (Honduras) | SCID Major depression (38%) | PHQ-9 (9) | 0–27 | 10 | 77 (46–94) | 100 (81–100) | NR | Poor |
| Aragonés Benaiges, 2001 (Spanish)35 | 350 Outpatients; primary care clinic (Spain) | SCID Major Depression (15%) | SDS (20) | 25–100 | 50 | 94 (83–100) | 70 (64–75) | 0.93 | Good |
| Baca, 1999 (Spanish)38 | 312 Primary care patients (Spain) | SCAN Depressionb (28%) | PRIME-MD-9 (9) | 0–9 | 5 | 72 (62–81) | 86 ( 80–90) | NR | Fair |
| Fernández-San Martín, 2002 (English)39 | 192 Patients age 65 y or older; 3 health centers (Spain) | GMS Major or minor depression (31%) | GDS (30) | 0–30 | 9 | 87 (78–95) | 63 (54–72) | 0.85 (0.79–0.91) | Fair |
| Garcia-Esteve, 2003 (English)36 | 334 Women; routine postpartum care (Spain) | SCID | EPDS (10) | 0–30 | 13 | 86 (77–92) | 95 (91–97) | 0.98 (0.97–0.99) | Good |
| Major depression (11%) Combined major or minor depression (30%) | 62 (44–79) | 98 (96–99) | 0.98 (0.97–0.98) | ||||||
| Martinez de la Iglesia 2002 (Spanish)43 | 249 Outpatients aged 65 y or older; 1 health center (Spain) | MADRS | GDS-15 | 15 | 5 | 81 (71–88) | 77 (69–83) | 0.84 (0.78–0.89) | Good |
| Depressionb (36%) | 73 (63–82) | 86 (80–91) | NR | ||||||
| Ortega-Orcos, 2007 (Spanish)37 | 301 Primary care patients aged >64 y (Spain) | DSM-IV-based clinical diagnosis | GDS-5 (5) | 0–5 | 2 | 86 (72–94) | 85 (80–89) | 0.86 (0.80–0.92) | Good |
| Depressionb (14.6%) | GDS-15 (15) | 0–15 | 5 | 82 (67–91) | 98 (95–99) | 0.90 (0.83–0.97) | |||