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Screening for Depression in Latino Immigrants: A Systematic Review of Depression Screening Instruments Translated into Spanish

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Abstract

The research on the diagnostic accuracy of Spanish language depression-screening instruments continues to be scarce in the US. Under-detection of depression by Primary Care Providers is approximately 50 % in the general population and this rate may be even higher for Latino immigrants for whom the depression rate tends to be higher than for non-Hispanic Whites. This systematic review shows that there is still limited evidence that guides primary care-based depression screening for Spanish speakers. The economic, social, and human costs of depression are high and complex; yet improvements in the effectiveness of treatment cannot be made available to sufferers of the disorder if they go undetected.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Francisco J. Limon.

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Conflict of interest

All of the authors declare that there are no conflicts of interest (financial or otherwise) to report.

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Appendix: Data Extraction Form

Appendix: Data Extraction Form

Study ID

First author

Years

Country

Language of administration

Date of reviewing

Reviewers initials

Any missed References (yes, no, do separate list)

Where sample was recruited

Clinical type: community, depressed, women

Outcomes: (verify depression is included, yes, no)

Study designs:

Case study

Cross-section

RCT

Other

Inclusion criteria

Exclusion criteria

Cut-off(s) reported

Was cut-off compared to minor, major, depression or unstated? Indicate for both cut-offs

Recruitment procedures: consecutive/random/add hock

Type of depression

All tests used

Quality grade (see table provided)

Name of interview used

Structured/semi-structured

Interviewer’s qualification

Interviewer trained to use interview?

Reference for interview

No. of participants available (original population)

% of those below cut-off

% of those above cut-off

% of sample not completing instrument

How was the instrument administered?

Delay b/w instrument interview?

Sensitivity

Specificity

LR +ve (1-sens)/spec

Diagnostic OR (LR +ve/LR −ve

PPV

NPV

Data to be requested from authors

*Study design

Case–control The comparison of individuals with a certain illness to similar healthy individuals. Matched by age, sex or other factors in order t define risk factors for the illness.

Cross-sectional The observation of a defined population at a single point in time or time interval. Exposure and outcomes are determined simultaneously.

RCT A true prospective experiment in which investigators randomly assign an eligible sample of patients to one or more groups and a control group and follow patient’s outcomes.

**Interview

Structured The interview has been specifically designed to diagnose depression in a given individual (it may also define other psychiatric conditions). There are specific questions and all relevant questions are asked of all interviews—the focus is quantitative.

Semi-structured The interview has been designed to elicit a number of different subjects or themes. Although there are set questions, the interviewer may choose to enquire further about areas of interest—the focus is qualitative. For this study, only structured interviews are eligible for inclusion.

Grade

Test accuracy

A

High quality studies with a blind comparison of test to reference standard in an appropriate population spectrum

B

Any one or two of the following

 Narrow population spectrum

 Differential use of reference standard

 Reference standard not blind

 Case control study

C

Any three or more of the above

D

Expert opinion

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Limon, F.J., Lamson, A.L., Hodgson, J. et al. Screening for Depression in Latino Immigrants: A Systematic Review of Depression Screening Instruments Translated into Spanish. J Immigrant Minority Health 18, 787–798 (2016). https://doi.org/10.1007/s10903-015-0321-y

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