Poststroke depression and anxiety: Different assessment methods result in variations in incidence and severity estimates

Patients with right and left hemisphere stroke (RH, LH) and a control group (CG) were administered a structured clinical interview (SCID-R) and rating scales for anxiety and depression (Center for Epidemiologic Studies Depres sion Scale, Beck Anxiety Inventory, and Hamiliton Dpression Rating Scale). The three groups did not differ when compared for the mean level of distres s on the rating scales or frequency of mood or anxiety disorder diagnosis u sing the SCID-R. By contrast, participants in the LH group were more likely to be classified as distressed using rating scales cutoff scores and on me asures of severity when compared only to the RH group. The rating scales we re sensitive to psychiatric disorders, but lacked specificity in all groups . There were significant correlations between scales suggesting the rating scales measure a common factor in the controls, while in the stroke groups associations were weaker and less likely to be significant. Together, these results suggest the need for caution in using rating scales of depression and anxiety in neurologic patients and support the notion that these scales are sensitive to distress rather than specific for identifying depressive and anxiety disorders.