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The diagnostic validity of depression scales and clinical judgement in the Kurdistan region of Iraq

Published online by Cambridge University Press:  02 January 2018

Zerak Al-salihy
Affiliation:
Norfolk and Suffolk Foundation Trust (NSFT), Bury St Edmunds, Suffolk, UK, email zeraksalihy@yahoo.com
Twana A. Rahim
Affiliation:
Faculty of Medicine, Hawler Medical University, Erbil, Iraq
Mahmud Q. Mahmud
Affiliation:
Azadi Medical Centre, Erbil, Iraq
Asma S. Muhyaldin
Affiliation:
Tairawa Health Centre, Erbil, Iraq
Alex J. Mitchell
Affiliation:
University of Leicester, UK
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Abstract

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We aimed to find the depression rating scale with the greatest accuracy when applied by psychiatrists in Iraqi Kurdistan. We recruited 200 patients with primary depression and 200 controls living in the Kurdistan region of Iraq. The Mini International Neuropsychiatry Inventory (MINI) was used as a gold standard for DSM-IV depression. We also used: the two-item and the nine-item versions of the Patient Health Questionnaire (PHQ2, PHQ9), the Hospital Anxiety and Depression Scale (HADS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Centre for Epidemiological Studies Depression (CES-D) scale. Interviews were performed by psychiatrists who also rated their clinical judgement using the Clinical Global Impression (CGI) scale and other mental health practitioners. All scales and tools performed with high accuracy and reliability. The least accurate tool was the PHQ2; however, with only two items it was efficient. Sensitivity and specificity for all tools were above 90%. Clinicians using the CGI were accurate in their clinical judgement. The CDSS appeared to be the most accurate scale for DSM-IV major depression and the PHQ2 the most efficient. However, only the CDSS appeared to offer an advantage over psychiatrists' judgement.

Type
Research papers
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Royal College of Psychiatrists 2012

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