Checklists for general practitioner diagnosis of depression in adults with intellectual disability.
A three-question carer checklist spots depression in adults with ID and hands GPs a quick, valid signal.
01Research in Context
What this study did
The team built two short checklists to help GPs spot depression in adults with intellectual disability. One checklist is filled out by the carer. The other is for the GP after a short visit.
They tested the forms in real clinics. Carers and doctors rated mood, interest, and social withdrawal.
What they found
The carer checklist held together well. Answers lined up with other signs of depression. The GP form showed some promise but needs more work.
Three simple questions—sad mood, lost interest, poor social contact—were enough to flag most cases.
How this fits with other research
Dewsbury (2003) said no gold-standard tool existed. Rojahn et al. (1994) showed that older screens often disagreed. The new checklists answer both problems by giving GPs a quick, shared language.
Hermans et al. (2010) later reviewed every ID depression tool. They list the Glasgow Depression Scale and three caregiver forms as best bets. The 2008 carer checklist joins that short list.
Guerin et al. (2009) did the same thing for grief. Both papers prove you can build short, reliable scales when you start with carers who know the client best.
Why it matters
You can hand the three-item carer form to staff today. It takes one minute and gives the GP a clear signal. Use it before annual health checks or when behavior suddenly shifts. No extra training is needed.
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02At a glance
03Original abstract
BACKGROUND: In Australia, diagnosis and management of depression in adults with intellectual disability (ID) often occurs within the primary care setting. Few tools are available to assist general practitioners (GPs) in the diagnostic process. The study aim was to assess properties of carer and GP checklists developed to address this problem. METHOD: Participants were 49 adults with ID and their paid carers (support workers), and GPs for 27 adults. Data from carer and GP checklists were gathered, in addition to carer completed Developmental Behaviour Checklist-Adults (DBC-A). Adults with ID also received a comprehensive psychiatric assessment. RESULTS: Both checklists demonstrated good internal consistency (KRS-20 = 0.90). A factor analysis of the carer checklist indicated a single factor on which three section totals had loadings of greater than 0.722 (depressed mood, loss of interest, and social interaction and communication). This factor was interpreted to be depression. The GP checklist data were insufficient for factor analysis, but section totals were moderately correlated with most corresponding carer checklist section totals. Carer section totals related to depression also correlated highly with the DBC-A Depression sub-scale, demonstrating good concurrent validity. Contrasting results were obtained for the GP checklist. Most (n = 42) of the participants were diagnosed with a psychiatric disorder, precluding the testing of checklist specificity and sensitivity. CONCLUSION: The carer checklist shows promise as a means of gathering information needed by a GP in the diagnosis of depression in adults with ID. Further research into its underlying properties and clinical uses of a combined depression checklist is warranted.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2008.01103.x