A surprisingly simple decision-making tool shows promise as a way for physicians to identify people with depression.
An answer to the first of four questions was all that researchers usually needed to identify women who weren’t depressed, say psychologist Mirjam Jenny of the Max Planck Institute for Human Development in Berlin and her colleagues. Using all four questions, this tool spotted depressed women about as well as two more-complex methods, Jenny’s team reports June 24 in the Journal of Applied Research in Memory and Cognition.
If the findings hold up in other studies, physicians and other professionals with no mental-health training could use this brief technique to tag individuals who need thorough depression evaluations. “This decision tree can be used to screen for depression, but not to reach a final diagnosis,” Jenny says.
Her team drew on data from 1,382 German women who completed a 21-item screening questionnaire for depression on two occasions, separated by 18 months. Based on this measure, depression initially affected 3.6 percent of the sample, or 50 individuals, and later appeared in 1.9 percent of the sample, or 26 individuals. Women’s initial responses to a handful of items that best predicted whether they would rank as depressed 18 months later were used to create a four-question decision tree.
The first question in the tree — “Have you cried more than usual in the last week?” — led the pack in identifying cases of depression. A “no” response to this or any of the other three questions — which inquired about feelings in the last week of disappointment or self-hate, discouragement about the future and personal failure — exempted women from being categorized as depressed. Those who responded “yes” to all four questions were classified as depressed.
The tool is impressive, remarks physician and health care researcher Glyn Elwyn of the Dartmouth Center for Health Care Delivery Science in Hanover, N.H. But it may not be sensitive to depression in men, he says.