Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Improving the precision of depression diagnosis in general practice: a cluster-randomized trial

Research output: Contribution to journalJournal articlepeer-review

  1. Deep learning-based integration of genetics with registry data for stratification of schizophrenia and depression

    Research output: Contribution to journalJournal articlepeer-review

  2. Neurocognitive Development in Children at Familial High Risk of Schizophrenia or Bipolar Disorder

    Research output: Contribution to journalJournal articlepeer-review

  3. Rating the importance of outcomes from diabetes trials. A survey of patients’ and doctors’ opinions

    Research output: Contribution to journalJournal articlepeer-review

View graph of relations

BACKGROUND: Methods to enhance the accuracy of the depression diagnosis continues to be of relevance to clinicians. The primary aim of this study was to compare the diagnostic precision of two different diagnostic strategies using the Mini International Neuropsychiatric Interview (MINI) as a reference standard. A secondary aim was to evaluate accordance between depression severity found via MINI and mean Major Depression Inventory (MDI) sum-scores presented at referral.

METHODS: This study was a two-armed, cluster-randomized superiority trial embedded in the Collabri trials investigating collaborative care in Danish general practices. GPs performing case-finding were instructed always to use MDI when suspecting depression. GPs performing usual clinical assessment were instructed to detect depression as they would normally do. According to guidelines, GPs would use MDI if they had a clinical suspicion, and patients responded positively to two or three core symptoms of depression. We compared the positive predictive value (PPV) in the two groups.

RESULTS: Fifty-one GP clusters were randomized. In total, 244 participants were recruited in the case-finding group from a total of 19 GP clusters, and 256 participants were recruited in the usual clinical assessment group from a total of 19 GP clusters. The PPV of the GP diagnosis, when based on case-finding, was 0.83 (95% CI 0.78-0.88) and 0.93 (95% CI 0.89-0.96) when based on usual clinical assessment. The mean MDI sum-scores for each depression severity group indicated higher scores than suggested cut-offs.

CONCLUSIONS: In this trial, systematic use of MDI on clinical suspicion of depression did not improve the diagnostic precision compared with the usual clinical assessment of depression.

TRIAL REGISTRATION: The trial was retrospectively registered on 07/02/2016 at ClinicalTrials.gov. No. NCT02678845 .

Original languageEnglish
Article number88
JournalBMC Family Practice
Volume22
Issue number1
ISSN1471-2296
DOIs
Publication statusPublished - 7 May 2021

    Research areas

  • Depression, Depressive Disorder, Major/diagnosis, General Practice, Humans, Psychiatric Status Rating Scales, Treatment Outcome
  • Health Sciences

ID: 74267004