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FC03-04 - The Importance of Measuring Functional Impairment with the Composite International Diagnostic Interview in Depression Research. A PredictD-Spain Study

Published online by Cambridge University Press:  17 April 2020

B. Moreno-Kustner
Affiliation:
Unidad de Investigación. (RedIAPP, SAMSERAP), Distrito Sanitario Málaga, Malaga Departamento de Personalidad, Evaluación y Tratamiento Psicológico
E. Motrico
Affiliation:
Departamento de Psicología Social, Universidad de Málaga
J. Bellón
Affiliation:
Unidad de Investigación. (RedIAPP, SAMSERAP), Distrito Sanitario Málaga Departamento de Medicina Preventiva, Universidad de Málaga, Málaga
M.J. Gil-de-Gómez-Barragán
Affiliation:
Unidad Docente de Medicina Familiar y Comunitaria de la Rioja, Servicio Riojano de la Salud, Logroño
M.A. Díaz-Barreiros
Affiliation:
Centro de Salud Vecindario, Servicio Canario de Salud, Las Palmas
M.T. Martínez-Cañavate
Affiliation:
Fundación IAVANTE, Servicio Andaluz de Salud, Granada
A. Vázquez-Medrano
Affiliation:
Unidad Docente de Medicina Familiar y Comunitaria de la Rioja, Servicio Riojano de la Salud, Logroño
S. March
Affiliation:
Unidad de Investigación de Atención Primaria de Baleares, Instituto Balear de la Salud, Mallorca
F. Torres-González
Affiliation:
Departamento de Psiquiatría y Medicina Legal, Universidad de Granada, Granada, Spain

Abstract

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Objective

To determine the association between functional impairment, as reported in a lay-administered structured interview (CIDI), and severity of depression, depressive symptoms and risk factors for depression.

Methods

We undertook a cross-sectional study of 5442 consecutive attendees at general practices in seven Spanish provinces participating in the PredictD-Spain study on predictors of depression. Participants were administered the depression section of the Composite International Diagnostic Interview (WHO-CIDI 2.1), allowing diagnoses by the ICD-10 and DSM-IV classifications for depressive episodes. Impairment was measured using the CIDI question about whether symptoms seriously interfered with important areas of functioning, such as work or looking after the house and family. We measured a set of 39 known risk factors for depression.

Results

Firstly, the 6-month prevalence of a depressive episode according to ICD-10 was 28.7% (1563) and of major depression according to DSM-IV it was 13.6% (742). Secondly, out of the 1563 patients with a depressive episode according to ICD-10, nearly half (47.9%; n=749) had no impairment in important areas of functioning.

Conclusions

As the ICD-10 criteria for depressive diagnoses do not include the criteria that symptoms cause impairment in social, occupational or other important areas of functioning, a large number of false positive cases are included in reported prevalence rates; and secondly, the measurement of functional impairment, at least operationalized using a lay-administered structured interview such as CIDI, is not enough, in epidemiological research studies, to assess the clinical importance of depressive symptoms.

Type
Free Communications
Copyright
Copyright © European Psychiatric Association 2010
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