Key Points
- To describe the development of the Depression Interview and Structured Hamilton (DISH) and evaluate its validity for diagnosing depression and quantifying symptom severity in medically ill patients.
- Administered the DISH and the Structured Clinical Interview for DSM-IV (SCID) in randomized order to 57 patients, comparing trained interviewers against clinicians.
- Assessed depression in the multicenter ENRICHD trial using DISH administered by trained research nurses, with clinicians independently reviewing 42% of interviews.
- Evaluated concurrent validity by administering the Beck Depression Inventory (BDI) and comparing it against the embedded 17-item Hamilton Depression scale in both studies.
- In the validity study (N=57), diagnostic agreement between the SCID and the DISH reached 88% (weighted κ = 0.86).
- In the ENRICHD trial, reviewing clinicians agreed with 93% of the diagnoses recorded by research nurses.
- DISH-derived Hamilton depression scores correlated significantly with BDI scores in both the validity study (r = 0.76, p < 0.0001) and ENRICHD (r = 0.64, p < 0.0001).
Structured PICO
Does the Depression Interview and Structured Hamilton (DISH) accurately diagnose depression compared to the SCID in medically ill patients?
PPopulation57 medically ill patients in the validity study, and patients after acute myocardial infarction in the ENRICHD study
IInterventionDepression Interview and Structured Hamilton (DISH)
CComparatorStructured Clinical Interview for DSM-IV (SCID)
OOutcomeDiagnostic agreement between DISH and SCID
The DISH is a valid and efficient semistructured interview for assessing depression and its severity in medically ill patients, such as those post-myocardial infarction.