A comparison of nine scales to detect depression in Parkinson disease

OBJECTIVE: The Methods of Optimal Depression Detection in Parkinson's Disease (MOOD-PD) study compared the psychometric properties of 9 depression scales to provide guidance on scale selection in Parkinson disease (PD). METHODS: Patients with PD (n = 229) from community-based neurology practices completed 6 self-report scales (Beck Depression Inventory BDI-II, Center for Epidemiologic Studies Depression Rating Scale-Revised CESD-R, 30-item Geriatric Depression Scale GDS-30, Inventory of Depressive Symptoms-Patient IDS-SR, Patient Health Questionnaire-9 PHQ-9, and Unified Parkinson's Disease Rating Scale UPDRS-Part I) and were administered 3 clinician-rated scales (17-item Hamilton Depression Rating Scale HAM-D-17, Inventory of Depressive Symptoms-Clinician IDS-C, and Montgomery-Åsberg Depression Rating Scale MADRS and a psychiatric interview. DSM-IV-TR diagnoses were established by an expert panel blinded to the self-reported rating scale data. Receiver operating characteristic curves were used to estimate the area under the curve (AUC) of each scale. RESULTS: All scales performed better than chance (AUC 0.75-0.85). Sensitivity ranged from 0.66 to 0.85 and specificity ranged from 0.60 to 0.88. The UPDRS Depression item had a smaller AUC than the BDI-II, HAM-D-17, IDS-C, and MADRS. The CESD-R also had a smaller AUC than the MADRS. The remaining AUCs were statistically similar. CONCLUSIONS: The GDS-30 may be the most efficient depression screening scale to use in PD because of its brevity, favorable psychometric properties, and lack of copyright protection. However, all scales studied, except for the UPDRS Depression, are valid screening tools when PD-specific cutoff scores are used.