How do you feel? Detection of recurrent Major Depressive Disorder using a single-item screening tool

Psychiatry Res. 2014 Dec 15;220(1-2):287-93. doi: 10.1016/j.psychres.2014.06.052. Epub 2014 Jul 10.


Mood is a key element of Major Depressive Disorder (MDD), and is perceived as a highly dynamic construct. The aim of the current study was to examine whether a single-item mood scale can be used for mood monitoring. One hundred thirty remitted out-patients were assessed using the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I), Visual Analogue Mood Scale (VAMS), 17-item Hamilton Depression Rating Scale (HAM-D17), and Inventory of Depressive Symptomatology-Self Report (IDS-SR). Of all patients, 13.8% relapsed during follow-up assessments. Area under the curves (AUCs) for the VAMS, HAM-D17 and IDS-SR were 0.94, 0.91, and, 0.86, respectively. The VAMS had the highest positive predictive value (PPV) without any false negatives at score 55 (PPV=0.53; NPV=1.0) and was the best predictor of current relapse status (variance explained for VAMS: 60%; for HAM-D17: 49%; for IDS-SR: 34%). Only the HAM-D17 added significant variance to the model (7%). Assessing sad mood with a single-item mood scale seems to be a straightforward and patient-friendly avenue for life-long mood monitoring. Using a diagnostic interview (e.g., the SCID) in case of a positive screen is warranted. Repeated assessment of the VAMS using Ecological Momentary Assessment (EMA) might reduce false positives.

Keywords: Affect; Depression; Relapse; Screening; Sensitivity; Specificity; Visual analogue scale.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / psychology*
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Emotions*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Personality Inventory / standards
  • Psychiatric Status Rating Scales / standards*
  • Recurrence
  • Young Adult