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Screening for mood disorders after stroke: a systematic review of psychometric properties and clinical utility

Published online by Cambridge University Press:  27 February 2014

L.-J. Burton  and
S. Tyson
L.-J. Burton
Affiliation:
Stroke and Vascular Research Centre, School of Nursing, Midwifery and Social Work, University of Manchester, UK
S. Tyson*
Affiliation:
Stroke and Vascular Research Centre, School of Nursing, Midwifery and Social Work, University of Manchester, UK
*
*Address for correspondence: S. Tyson, F.C.S.P., M.Sc., Ph.D., Stroke and Vascular Research Centre, School of Nursing, Midwifery and Social Work, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK. (Email: Sarah.Tyson@Manchester.ac.uk)
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Abstract

Background

Routine mood screening is recommended after stroke. However, clinicians report difficulty selecting appropriate tools from the wide range available. We aimed to systematically review the psychometric properties and clinical utility of mood screening tools for stroke survivors.

Method

Electronic databases (AMED, EMBASE, CINAHL, Medline and PsycINFO) were searched to identify studies assessing the sensitivity and specificity of mood screening tools. Tools that demonstrated at least 80% sensitivity and 60% specificity with stroke survivors with identifiable cut-off scores indicating major and/or any mood disorder in at least one study were selected and clinical utility was assessed. Those with high clinical utility (against predefined criteria) were selected for recommendation.

Results

Thirty papers examining 27 screening tools were identified and 16 tools met the psychometric and clinical utility criteria: 10 were verbal self-report tools, four were observational and two incorporated visual prompts for those with communication problems. Only the Stroke Aphasic Depression Questionnaire –Hospital version (SADQ-H) met all the psychometric and utility criteria. The nine-item Patient Health Questionnaire (PHQ-9) can detect major depression and the 15-item Geriatric Depression Scale (GDS-15) can identify milder symptoms; both are feasible to use in clinical practice. The Hospital Anxiety and Depression Scale (HADS) was the only tool able to identify anxiety accurately, but clinical utility was mixed.

Conclusions

Valid and clinically feasible mood screening tools for stroke have been identified but methodological inconsistency prevented recommendations about the optimal cut-off scores.

Keywords

Moodreviewscreeningstroke
Type
Review Articles
Information
Psychological Medicine , Volume 45 , Issue 1 , January 2015 , pp. 29 - 49
Copyright
Copyright © Cambridge University Press 2014 

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