Depression screening in a women's clinic: Using automated Spanish- and English-language voice recognition

Clinical depression is frequently unrecognized, even in health care setting s. This study (a) reports high levels of major depressive episodes (MDEs) a nd depressive symptoms in a public sector women's clinic, Ib) compares comp uterized voice recognition with live interviews, and (c) compares Spanish a nd English versions of the depression-screening instruments. Patients (N = 104) completed face-to-face interviews and/or computerized voice recognitio n interviews in counterbalanced order; 38% scored positive for current MDE, and 67% scored positive for lifetime MDE. The mean score on the Center for Epidemiological Studies Depression scale (CES-D) was 22.1 (SD = 12.1), wit h 68% scoring 16 or above. No differences were found on either measure betw een English and Spanish speakers. Overall agreement between computer and li ve interviews was as follows: kappa =.82 for both current and lifetime MDE and r =.89 for CES-D scores. Kappas between the MDE Screener developed for this study and the Primary Care Evaluation of Mental Disorders were .75 for live interviews and .81 for the computerized version. Depression screening with computerized voice recognition methods yielded results comparable wit h those of live interviews in both English and Spanish.