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Validity of the Beck Depression Inventory, Hospital Anxiety and Depression Scale, SCL-90, and Hamilton Depression Rating Scale as Screening Instruments for Depression in Stroke Patients

Received June 22, 2001; revision received Feb. 8, 2002; accepted Feb. 13, 2002. From the Departments of Psychiatry and Neurology, University Hospital Maastricht. Address reprint requests to Dr. Honig, Department of Psychiatry, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands.

Most instruments used to assess poststroke depression have never been specifically validated in stroke patients. This study evaluated the depression screening abilities of three questionnaires and one observer-rated scale in 202 consecutive patients 1 month after they experienced their first-ever ischemic stroke. At their respective optimum cutoff values, the sensitivity of the self-rated scales varied between 80% and 90%, while the specificity was about 60%. For the observer-rated scale (Hamilton Depression Rating Scale), sensitivity was 78.1%, and specificity was 74.6%. The instruments clearly performed better in men than in women. Despite this difference, it was concluded that all scales were acceptable screening instruments for poststroke depression.

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