Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review

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dc.contributor.authorAkena, Dickensen_ZA
dc.contributor.authorJoska, Johnen_ZA
dc.contributor.authorObuku, Ekwaroen_ZA
dc.contributor.authorAmos, Tarynen_ZA
dc.contributor.authorMusisi, Segganeen_ZA
dc.contributor.authorStein, Danen_ZA
dc.date.accessioned2015-11-18T04:02:02Z
dc.date.available2015-11-18T04:02:02Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: Given the high prevalence of depression in primary health care (PHC), the use of screening instruments has been recommended. Both brief and long depression screening instruments have been validated in low and middle income countries (LMIC), including within HIV care settings. However, it remains unknown whether the brief instruments validated in LMIC are as accurate as the long ones. METHODS: We conducted a search of PUBMED, the COCHRANE library, AIDSLINE, and PSYCH-Info from their inception up to July 2011, for studies that validated depression screening instruments in LMIC. Data were extracted into tables and analyzed using RevMan 5.0 and STATA 11.2 for the presence of heterogeneity. RESULTS: Nineteen studies met our inclusion criteria. The reported prevalence of depression in LMIC ranged from 11.1 to 53%. The area under curve (AUC) scores of the validated instruments ranged from 0.69-0.99. Brief as well as long screening instruments showed acceptable accuracy (AUC[greater than or equal to]0.7). Five of the 19 instruments were validated within HIV settings. There was statistically significant heterogeneity between the studies, and hence a meta-analysis could not be conducted to completion. Heterogeneity chi-squared = 189.23 (d.f. = 18) p<.001. CONCLUSION: Brief depression screening instruments in both general and HIV-PHC are as accurate as the long ones. Brief scales may have an edge over the longer instruments since they can be administered in a much shorter time. However, because the ultra brief scales do not include the whole spectrum of depression symptoms including suicide, their use should be followed by a detailed diagnostic interview.en_ZA
dc.identifier.apacitationAkena, D., Joska, J., Obuku, E., Amos, T., Musisi, S., & Stein, D. (2012). Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review. <i>BMC Psychiatry</i>, http://hdl.handle.net/11427/15099en_ZA
dc.identifier.chicagocitationAkena, Dickens, John Joska, Ekwaro Obuku, Taryn Amos, Seggane Musisi, and Dan Stein "Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review." <i>BMC Psychiatry</i> (2012) http://hdl.handle.net/11427/15099en_ZA
dc.identifier.citationAkena, D., Joska, J., Obuku, E. A., Amos, T., Musisi, S., & Stein, D. J. (2012). Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review. BMC psychiatry, 12(1), 187.en_ZA
dc.identifier.ris TY - Journal Article AU - Akena, Dickens AU - Joska, John AU - Obuku, Ekwaro AU - Amos, Taryn AU - Musisi, Seggane AU - Stein, Dan AB - BACKGROUND: Given the high prevalence of depression in primary health care (PHC), the use of screening instruments has been recommended. Both brief and long depression screening instruments have been validated in low and middle income countries (LMIC), including within HIV care settings. However, it remains unknown whether the brief instruments validated in LMIC are as accurate as the long ones. METHODS: We conducted a search of PUBMED, the COCHRANE library, AIDSLINE, and PSYCH-Info from their inception up to July 2011, for studies that validated depression screening instruments in LMIC. Data were extracted into tables and analyzed using RevMan 5.0 and STATA 11.2 for the presence of heterogeneity. RESULTS: Nineteen studies met our inclusion criteria. The reported prevalence of depression in LMIC ranged from 11.1 to 53%. The area under curve (AUC) scores of the validated instruments ranged from 0.69-0.99. Brief as well as long screening instruments showed acceptable accuracy (AUC[greater than or equal to]0.7). Five of the 19 instruments were validated within HIV settings. There was statistically significant heterogeneity between the studies, and hence a meta-analysis could not be conducted to completion. Heterogeneity chi-squared = 189.23 (d.f. = 18) p<.001. CONCLUSION: Brief depression screening instruments in both general and HIV-PHC are as accurate as the long ones. Brief scales may have an edge over the longer instruments since they can be administered in a much shorter time. However, because the ultra brief scales do not include the whole spectrum of depression symptoms including suicide, their use should be followed by a detailed diagnostic interview. DA - 2012 DB - OpenUCT DO - 10.1186/1471-244X-12-187 DP - University of Cape Town J1 - BMC Psychiatry LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review TI - Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review UR - http://hdl.handle.net/11427/15099 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15099
dc.identifier.urihttp://dx.doi.org/10.1186/1471-244X-12-187
dc.identifier.vancouvercitationAkena D, Joska J, Obuku E, Amos T, Musisi S, Stein D. Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review. BMC Psychiatry. 2012; http://hdl.handle.net/11427/15099.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2012 Akena et al.; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Psychiatryen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpsychiatry/en_ZA
dc.subject.otherDepressionen_ZA
dc.subject.otherPrimary Health Careen_ZA
dc.subject.otherHIV care settingsen_ZA
dc.titleComparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic reviewen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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