Sukontip K. Face Mood Pictorial Depression Assessment Tool - เครื่องมือประเมินภาวะซึมเศร้าด้วยรูปภาพ

Abstract

           Depressive disorders are the second disease burden in the world, and first cause of years of life lost due to disability - YLDs. The screening for depressive disorders in Chiangdao district had not reached the target because of language and cultural barriers in many groups of Thai hill tribe people. The Sukontip K. face mood pictorial depression assessment tool was developed to solve these problems. The objective of this study was to determine the diagnostic accuracy of the tool in the screening for depression in Thai community. It was conducted in 100 randomly selected participants aged 18 and above attending out patient department of Suanprung Hospital from October through December 2011 (50 depressive and 50 non-depressive participants diagnosed by psychiatrists). Patients with schizophrenia and mental retardation were excluded. The participants were assessed for their depressive mood by the Sukontip K. face mood pictorial depression assessment tool and the Thai version of the patient health questionnaire (PHQ-9). Confirmatory diagnosis (depression or no depression) was subsequently performed by psychiatrists. Data were collected and analyzed for sensitivity, specificity, likelihood ratios for positive and negative results,
and area under receiver operating characteristic curve (AUC) with 95% confidence interval (95%CI). It was found that the mean age of the participants was 45.47 years (SD = 13.06) and 53.00% of them were
females. Depression was found in 50 subjects, and no depression in the other 50 subjects. The average assessment time by this screening took was approximately 10 seconds. The optimal cut-off point was picture No. 4 that showed a sensitivity of 78.00% (95%CI 64.76-87.25), specificity of 82.00 (95%CI= 69.20 - 90.23). The area under the curve (AUC) in this screening test was 0.83 (95%CI 0.75 - 0.92), positive predictive value = 81.25% (95 % CI 68.06 – 89.81), negative predictive value = 78.85% (95% CI 65.97 – 87.76), positive likelihood ratio = 4.33 (95%CI 2.36 - 7.97) and negative
likelihood ratio = 0.27 (95%CI 0.16 - 0.46). The average time to complete the PHQ-9 was approximately 5 to 10 minutes. The accuracy of PHQ-9 showed a sensitivity of 76.00 (95%CI 62.59 - 85.70), specificity of 76.00 (95%CI 62.59 - 85.70), positive likelihood ratio of 3.17 (95%CI 1.88
– 5.31) and negative likelihood ratio of 0.32 (95%CI 0.19 – 0.53). The AUC of PHQ-9 was 0.86 (95%CI 0.79 - 0.94). Thus, the Sukontip K. face mood pictorial depression assessment tool was found to be a reliable depression screening tool. It took less time (compared to PHQ-9), was easy to use and had no language or cultural barrier. It could, therefore, replace PHQ-9, as there was no statistical significant difference in the accuracy.
Key words: Sukontip K. face mood pictorial depression assessment tool, sensitivity, specificity, depression