Insights Provided by Depression Screening Regarding Pain, Anxiety, and Substance use in a Veteran Population
| Autor: | David A. Fiellin, Natalie E. Chichetto, Ellen C. Caniglia, Kailyn E. Young, E. Jennifer Edelman, Amy C. Justice, Medha Mazumdar, Stephen A. Maisto, Julie R. Gaither, Elizabeth R. Stevens, Maria R. Khan, Adam J. Gordon, R. Scott Braithwaite, Stephan Crystal |
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| Rok vydání: | 2020 |
| Předmět: |
co-occurring
medicine.medical_specialty Substance-Related Disorders Population Pain Pain Interference Primary care Anxiety lcsh:Computer applications to medicine. Medical informatics Cohort Studies 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires screening tool medicine Humans Mass Screening veterans 030212 general & internal medicine Psychiatry education Depression (differential diagnoses) Original Research Community and Home Care education.field_of_study Pain related anxiety Depression business.industry lcsh:Public aspects of medicine Public Health Environmental and Occupational Health lcsh:RA1-1270 Middle Aged Depression screening lcsh:R858-859.7 Substance use medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Primary Care & Community Health Journal of Primary Care & Community Health, Vol 11 (2020) |
| ISSN: | 2150-1327 |
| DOI: | 10.1177/2150132720949123 |
| Popis: | Objective: We sought to quantify the extent to which a depression screening instrument commonly used in primary care settings provides additional information regarding pain interference symptoms, anxiety, and substance use. Methods: Veterans Aging Cohort Study (VACS) data collected from 2003 through 2015 was used to calculate odds ratios (OR) for associations between positive depression screening result cutoffs and clustering conditions. We assessed the test performance characteristics (likelihood ratio value, positive predictive value, and the percentage of individuals correctly classified) of a positive Patient Health Questionnaire (PHQ-9 & PHQ-2) depression screen for the identification of pain interference symptoms, anxiety, and substance use. Results: A total 7731 participants were included in the analyses. The median age was 50 years. The PHQ-9 threshold of ≥20 was strongly associated with pain interference symptoms (OR 21.6, 95% CI 17.5-26.7) and anxiety (OR 72.1, 95% CI 52.8-99.0) and yielded likelihood ratio values of 7.5 for pain interference symptoms and 21.8 for anxiety and positive predictive values (PPV) of 84% and 95%, respectively. A PHQ-9 score of ≥10 still showed significant associations with pain interference symptoms (OR 6.1, 95% CI 5.4-6.9) and symptoms of anxiety (OR 11.3, 95% CI 9.7-13.1) and yet yielded lower likelihood ratio values (4.36 & 8.24, respectively). The PHQ-9 was less strongly associated with various forms of substance use. Conclusion: Depression screening provides substantial additional information regarding the likelihood of pain interference symptoms and anxiety and should trigger diagnostic assessments for these other conditions. |
| Databáze: | OpenAIRE |
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