SCREENING OF DEPRESSION IN PATIENTS WITH CHRONIC MEDICAL DISEASES IN A PRIMARY-CARE SETTING

Background. Patients with chronic medical diseases may have depression that is not recognized by their primary care physicians. Objectives. We aimed to examine the application of Zung's Self-Rating Depression S cale (SDS) in the screening of depression in primary care patients wit h chronic medical diseases in a Chinese population. Methods. We studie d 268 patients with chronic medical diseases in the Family Medicine Ou tpatient Clinic using a structured questionnaire including basic demog raphic data, a Chinese version of the SDS and a rating for the self-pe rceived severity of physical condition. The severity of chronic medica l diseases was assessed by the authors using the Duke University Sever ity of Illness Scale from a chart audit. Fifty patients were randomly selected for a diagnostic interview according to the DSM-IV criteria. The construct validity and internal consistency reliability, sensitivi ty and specificity of the SDS were examined. Results. The results reve aled that the SDS has good construct validity and internal consistent reliability in the evaluation of depression in Chinese patients with c hronic medical diseases. A cut-off point of 55 had a sensitivity of 66 .7% and a specificity of 90.0%. Depressed patients reported more cogni tive symptoms than depressed affect and physical symptoms. Female pati ents had more severe depressed affect than male patients, but males ha d more prominent diurnal variation of mood than females. Conclusions. We concluded that SDS can be a good screening tool for depression in C hinese patients with chronic medical diseases. Owing to constraints in the expression of sexual desire in the Chinese, elderly subjects tend ed to report loss of libido in the response to the SDS.