Computerized Adaptive Testing - Depression Inventory

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DESCRIPTION (provided by applicant): Depression costs the United States $40 billion annually (Rice & Miller, 1998). Unipolar depression alone ranked fourth among the leading causes of disability-adjusted life years (DALYs) in both sexes and all age groups in 2000 (WHO, 2001). In addition, psychiatric disorders are often chronic and have a profound impact on other chronic medical illnesses. In 2002, the U.S. Preventive Services Task Force endorsed depression screening in general medical practice but did not recommend a specific screening tool (Pignone, Gaynes, Rushton et al., 2002). Community clinics play a pivotal role in the detection and treatment of depressive disorders. However, depression screeners in community or primary care clinics are usually brief with some studies using as few as 2 questions orally asked by the physician (Arroll, Khin, & Kerse, 2005). The proposed supplemental (revision) research will expand the nature of the current grant by investigating the efficacy of depression scale items administered in a computerized adaptive testing (CAT) environment for the diagnostic classification of Major Depressive Disorder (MDD), based on the Diagnostic and Statistical Manual of Mental Disorders - IV (DSM-IV; American Psychiatric Association, 1994). This endeavor builds on the ongoing research by (a) developing a bank of patient reported scale items (approximately 100) designed specifically to correspond to the DSM-IV criteria for MDD diagnosis, (b) developing and evaluating four statistical models to identify individuals experiencing MDD from those who are not, and (c) comparing MDD diagnosis based on CAT to traditional DSM diagnosis. The ability of the methodology to differentiate minor from major depression will also be investigated. This research represents a major advance in the use of patient reported outcomes to diagnose depression. PUBLIC HEALTH RELEVANCE: Depression costs the United States $40 billion annually (Rice & Miller, 1998). In 2002, the U.S. Preventive Services Task Force endorsed depression screening in general medical practice but did not recommend a specific screening tool (Pignone, Gaynes, Rushton et al., 2002). The proposed research responds to this important recommendation by developing a new paradigm for the rapid diagnosis of major depressive disorder (MDD) based on a novel application of computer adaptive testing (CAT) and item response theory. The resulting CAT-based MDD diagnostic system provides a screening tool that can be used in both psychiatric and primary care settings, and is based on patient reported outcomes.