Depression screening for HIV/AIDS patientsDepression screening can be a challenging process with HIV/AIDS patients. Tamara Cafaro, RN of Riverview Medical Center wanted to assess the complete picture prior to deciding what tool to use. She led a team through the analysis of what the research to date has shown to guide her tool section. The sensitivity of the BDI-II ranged from 81%-94% and its specificity was shown to be 92%. Psychometric evaluation of the PHQ-9 revealed a sensitivity ranging from 62%-92% and a specificity between 74%-88%. (It may be noted that the low ranges of sensitivity and specificity for the PHQ-9 resulted from a single study involving an older HIV-positive population.) Three of the articles related to the PHQ-9 were conducted with an HIV population, versus none in the BDI-II primary literature concerning psychometrics. Apart from the psychometrics of each tool, several factors need to be considered in choosing an appropriate tool for annual depression screening in this population.
First, the BDI-II may be costly, starting at over $150 for manual and 25 screens and each additional packet of 25 costing from $75 upward. It is also time consuming, with the literature reporting about 3 minutes with a 5 minute administration time recommended. Despite the somewhat less positive psychometric properties demonstrated by the PHQ-9, as seen in this review, it may be noted that the screen entails no cost for use, was shown to require less than 1 minute for administration and involves what may been seen as a less complicated language style. The team’s final decision was to use the PHQ-9 for the ambulatory HIV/AIDS patient screening for depression.