Is the BPRS-5 subscale of the psychotic depression assessment scale a reliable screening tool for psychotic depression?: Results from the CRESCEND Study

Background: The detection of psychotic depression(PD)among patients with depressive disorders is important for both treatment and monitoring.Therefore, in continuation of our previous work, this studyAimed to test the ability... [ view full abstract ]

Background: The detection of psychotic depression(PD)among patients with depressive disorders is important for both treatment and monitoring.Therefore, in continuation of our previous work, this study

Aimed to test the ability of the five-item BriefPsychiatric Rating Scale (BPRS-5) of the Psychotic Depression Assessment Scale(PDAS)in separating patients with psychotic depression from those with non-psychotic depression(non-PD)and to compare this discriminative validity to that of other item sets.

Methods: A receiver operating characteristicscurve was used to identify the optimal cut-off score of the BPRS-5 subscale forsensitive and specific distinction between PD and non-PD in a sample of 494 patientswith depressive disorders (53 with PD and 441 with non-PD).

Results: Using an optimal cut-off score of 1,the sensitivity and the specificity of the BPRS-5 subscale in detecting PD were71.2% and 87.2%, respectively. The BPRS-5 outperformed other item sets of the PDASand the positive symptom subscale of the BPRS in identifying patients with PD.

Conclusions: TheBPRS-5 subscale can be regardedas a more sensitive screening method for PD compared to other item sets from thePDAS and the BPRS. Hence, from a screening perspective, a positive score on anyof the five symptoms of the BPRS-5 subscale (hallucinatory behavior, unusual thoughtcontent, suspiciousness, blunted affect, and emotional withdrawal) is indicativeof PD, and should lead to more thorough diagnostic assessment.