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      Depression in Multiple Sclerosis: A Review of Assessment and Treatment Approaches in Adult and Pediatric Populations

      review-article
      , , *
      ISRN Neurology
      International Scholarly Research Network

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          Abstract

          Multiple sclerosis is a chronic demyelinating disease affecting one million people worldwide, with a significant burden of psychiatric comorbidity. Depression is the commonest psychiatric manifestation but still remains largely underdiagnosed and undertreated. The present work reviews current knowledge on diagnosis, assessment, and somatic and psychotherapeutic treatment interventions for depression in adult and pediatric populations of patients with multiple sclerosis.

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          Most cited references90

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          A SELF-RATING DEPRESSION SCALE.

          W W Zung (1965)
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            International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results.

            More than 200 published studies from most medical settings worldwide have reported experiences with the Hospital Anxiety and Depression Scale (HADS) which was specifically developed by Zigmond and Snaith for use with physically ill patients. Although introduced in 1983, there is still no comprehensive documentation of its psychometric properties. The present review summarizes available data on reliability and validity and gives an overview of clinical studies conducted with this instrument and their most important findings. The HADS gives clinically meaningful results as a psychological screening tool, in clinical group comparisons and in correlational studies with several aspects of disease and quality of life. It is sensitive to changes both during the course of diseases and in response to psychotherapeutic and psychopharmacological intervention. Finally, HADS scores predict psychosocial and possibly also physical outcome.
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              Case-finding instruments for depression. Two questions are as good as many.

              To determine the validity of a two-question case-finding instrument for depression as compared with six previously validated instruments. The test characteristics of a two-question case-finding instrument that asks about depressed mood and anhedonia were compared with six common case-finding instruments, using the Quick Diagnostic Interview Schedule as a criterion standard for the diagnosis of major depression. Urgent care clinic at the San Francisco Department of Veterans Affairs Medical Center. Five hundred thirty-six consecutive adult patients without mania or schizophrenia. Measurements were two questions from the Primary Care Evaluation of Mental Disorders patient questionnaire, both the long and short forms of the Center for Epidemiologic Studies Depression Scale, both the long and short forms of the Book Depression Inventory, the Symptom-Driven Diagnostic System for Primary Care, the Medical Outcomes Study depression measure, and the Quick Diagnostic Interview Schedule. The prevalence of depression, as determined by the standardized interview, was 18% (97 of 536). Overall, the case-finding instruments had sensitivities of 89% to 96% and specificities of 51% to 72% for diagnosing major depression. A positive response to the two-item instrument had a sensitivity of 96% (95% confidence interval [CI], 90-99%) and a specificity of 57% (95% CI 53-62%). Areas under the receiver operating characteristic curves were similar for all of the instruments, with a range of 0.82 to 0.89. The two-question case-finding instrument is a useful measure for detecting depression in primary care. It has similar test characteristics to other case-finding instruments and is less time-consuming.
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                Author and article information

                Journal
                ISRN Neurol
                ISRN Neurol
                ISRN.NEUROLOGY
                ISRN Neurology
                International Scholarly Research Network
                2090-5505
                2090-5513
                2012
                14 October 2012
                : 2012
                : 427102
                Affiliations
                Department of Psychiatry, School of Medicine and University Hospital of Patras, University of Patras, Rio, 26504 Patras, Greece
                Author notes
                *Philippos Gourzis: pgourzis@ 123456upatras.gr

                Academic Editors: M. G. Grasso and Y. Wang

                Article
                10.5402/2012/427102
                3477767
                23097716
                403d8cca-1ddc-45f0-a862-dec9ba6cde59
                Copyright © 2012 Maria Skokou et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 August 2012
                : 17 September 2012
                Categories
                Review Article

                Neurology
                Neurology

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