Disability and perceived stress in primary care patients with major depression

  1. Jesús Santolaya Prego de Oliver 1
  2. Roger Muñoz-Navarro 2
  3. César González-Blanch 3
  4. Ana Llorca-Mestre 4
  5. Elisabeth Malonda 4
  6. Leonardo Medrano 5
  7. Paloma Ruiz-Rodríguez 6
  8. Juan Antonio Moriana 7
  9. Antonio Cano-Vindel 8
  1. 1 Universidad Europea de Valencia
    info

    Universidad Europea de Valencia

    Valencia, España

  2. 2 Universidad de Zaragoza
    info

    Universidad de Zaragoza

    Zaragoza, España

    ROR https://ror.org/012a91z28

  3. 3 Hospital Universitario “Marqués de Valdecillas” (Santander)
  4. 4 Universitat de València
    info

    Universitat de València

    Valencia, España

    ROR https://ror.org/043nxc105

  5. 5 Pontificia Universidad Católica Madre y Maestra (República Dominicana)
  6. 6 Servicio Madrileño de Salud
    info

    Servicio Madrileño de Salud

    Madrid, España

  7. 7 Universidad de Córdoba
    info

    Universidad de Córdoba

    Córdoba, España

    ROR https://ror.org/05yc77b46

  8. 8 Universidad Complutense de Madrid
    info

    Universidad Complutense de Madrid

    Madrid, España

    ROR 02p0gd045

Revista:
Psicothema

ISSN: 0214-9915 1886-144X

Año de publicación: 2020

Volumen: 32

Número: 2

Páginas: 167-175

Tipo: Artículo

DOI: 10.7334/PSICOTHEMA2019.319 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Psicothema

Objetivos de desarrollo sostenible

Resumen

Background: Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9). Method: A total of 1,704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9. We evaluated the factor structure, measurement invariance across gender, internal consistency, and the discriminative and predictive validity. Results: Confirmatory factor analyses revealed a unifactorial model of the SDS containing 4 items (SDS-4) with the best model fit (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). This model contained the three life domain items (work, family, and social life) plus perceived stress (PS) with significant loadings. The internal consistency of the SDS-4 was acceptable in patients with or without MDD, regardless of symptom severity. The SDS-4 also showed good discriminative capacity and acceptable predictive validity in all subsamples. Conclusions: These findings support the use of the SDS-4 to assess depression-related disability in patients at Spanish primary care centres.

Información de financiación

This work has been supported by the Fundación Española para la Promoción y el Desarrollo Científico y Profesional de la Psicología to Antonio Cano-Vindel; by the Agencia Estatal de Investigación (PSI2012-36589) to Antonio Cano-Vindel; by the IDIVAL, INNVAL (ref.: 16/08) and PRIMVAL (ref.: 18/03) to César González-Blanch; and by the Agencia Estatal de Investigación (SI2014-56368-R) to Juan A. Moriana We thank all the PsicAP Research Group members who kindly participated in this large project.

Referencias bibliográficas

  • Arbuckle, R., Frye, M. A., Brecher, M., Paulsson, B., Rajagopalan, K., Palmer, S., & Degl’ Innocenti, A. (2009). The psychometric validation of the Sheehan Disability Scale (SDS) in patients with bipolar disorder. Psychiatry Research, 165(1-2), 163-174. https://doi.org/10.1016/j. psychres.2007.11.018
  • Bianchi, R., Schonfeld, I. S., & Laurent, E. (2015). Burnout-depression overlap: A review. Clinical Psychology Review, 36, 28-41. https://doi. org/10.1016/J.CPR.2015.01.004
  • Bobes, J., Badia, X., Luque, A., García, M., González, M. P., & Dal-Ré, R. (1999). Validation of the Spanish version of the Liebowitz social anxiety scale, social anxiety and distress scale and Sheehan disability inventory for the evaluation of social phobia. Medicina clínica, 112(14), 530-538.
  • Cano-Vindel, A., Muñoz-Navarro, R., Wood, C. M., Limonero, J. T., Medrano, L. A., Ruiz-Rodríguez, P., … Santolaya, F. (2016). Transdiagnostic cognitive behavioral therapy versus treatment as usual in adult patients with emotional disorders in the primary care setting (PsicAP Study): Protocol for a randomized controlled trial. JMIR Research Protocols, 5(4), e246. https://doi.org/10.2196/resprot.6351
  • Fernández, A., Pinto-Meza, A., Bellón, J. A., Roura-Poch, P., Haro, J. M., Autonell, J., … Serrano-Blanco, A. (2010). Is major depression adequately diagnosed and treated by general practitioners? Results from an epidemiological study. General Hospital Psychiatry, 32(2), 201-209. https://doi.org/10.1016/j.genhosppsych.2009.11.015
  • Friedrich, M. J. (2017). Depression Is the Leading Cause of Disability Around the World. Jama, 317(15), 1517-1517. https://doi.org/10.1001/ jama.2017.3826
  • González-Blanch, C., Fernando Hernández-de-Hita, Muñoz-Navarro, R., Ruiz-Rodríguez, P., Medrano, L. A., Moriana, J. A., & CanoVindel, A. (2018a). Domain-specifi c associations between disability and depression, anxiety, and somatization in primary care patients. Psychiatry Research, 269, 596-601. https://doi.org/10.1016/j. psychres.2018.09.007
  • González-Blanch, C., Hernández-de-Hita, F., Muñoz-Navarro, R., RuizRodríguez, P., Medrano, L. A., & Cano-Vindel, A. (2018b). The association between different domains of quality of life and symptoms in primary care patients with emotional disorders. Scientifi c Reports, 8(1), 11180. https://doi.org/10.1038/s41598-018-28995-6
  • González-Blanch, C., Medrano, L. A., Muñoz-Navarro, R., RuizRodríguez, P., Moriana, J. A., Limonero, J. T., … Cano-Vindel, A. (2018c). Factor structure and measurement invariance across various demographic groups and over time for the PHQ-9 in primary care patients in Spain. PLoS ONE, 13(2), e0193356. https://doi.org/10.1371/ journal.pone.0193356
  • Hambrick, J. P., Turk, C. L., Heimberg, R. G., Schneier, F. R., & Liebowitz, M. R. (2004). Psychometric properties of disability measures among patients with social anxiety disorder. Journal of Anxiety Disorders, 18(6), 825-839. https://doi.org/10.1016/j.janxdis.2003.10.004
  • Hodgins, D. C. (2013). Reliability and validity of the Sheehan disability scale modifi ed for pathological gambling. BMC Psychiatry, 13(1), 177186. https://doi.org/10.1186/1471-244X-13-177
  • Hu, L., & Bentler, P. M. (1998). Cutoff criteria for fi t indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118
  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. https://doi.org/10.1046/j.15251497.2001.016009606.x
  • Leon, A. C., Shear, M. K., Portera, L., & Klerman, G. L. (1992). Assessing impairment in patients with panic disorder: the Sheehan Disability Scale. Social Psychiatry and Psychiatric Epidemiology, 27(2), 78-82. https://doi.org/10.1007/BF00788510
  • Leon, Andrew C., Olfson, M., Portera, L., Farber, L., & Sheehan, D. V. (1997). Assessing psychiatric impairment in primary care with the Sheehan Disability Scale. International Journal of Psychiatry in Medicine, 27(2), 93-105. https://doi.org/10.2190/T8EM-C8YH-373N1UWD
  • Luciano, J. V., Bertsch, J., Salvador-Carulla, L., Tomás, J. M., Fernández, A., Pinto-Meza, A., … Serrano-Blanco, A. (2010). Factor structure, internal consistency and construct validity of the Sheehan Disability Scale in a Spanish primary care sample. Journal of Evaluation in Clinical Practice, 16(5), 895-901. https://doi.org/10.1111/j.13652753.2009.01211.x
  • Mitchell, A. J., Yadegarfar, M., Gill, J., & Stubbs, B. (2016). Case fi nding and screening clinical utility of the Patient Health Questionnaire (PHQ-9 and PHQ-2) for depression in primary care: A diagnostic meta-analysis of 40 studies. BJPsych Open, 2(2), 127-138. https://doi.org/10.1192/ bjpo.bp.115.001685
  • Muñiz, J., & Fonseca-Pedrero, E. (2019). Ten steps for test development. Psicothema, 31(1), 7-16. doi:10.7334/psicothema2018.291
  • Muñoz-Navarro, R., Cano-Vindel, A., Medrano, L. A., Schmitz, F., RuizRodríguez, P., Abellán-Maeso, C., … Hermosilla-Pasamar, A. M. (2017a). Utility of the PHQ-9 to identify major depressive disorder in adult patients in Spanish primary care centres. BMC Psychiatry, 17(1), 291-300. https://doi.org/10.1186/s12888-017-1450-8
  • Muñoz-Navarro, R., Cano-Vindel, A., Ruiz-Rodríguez, P., Adrián Medrano, L., González-Blanch, C., Moriana, J. A., … DongilCollado, E. (2017b). Diagnostic and referral hierarchical model of common mental disorders in primary care centers. The PsicAP clinical trial approach. Ansiedad y Estrés, 23(2-3), 124-129. https://doi. org/10.1016/j.anyes.2017.10.002
  • Navarro-Mateu, F., Tormo, M. J., Salmerón, D., Vilagut, G., Navarro, C., Ruiz-Merino, G., … Alonso, J. (2015). Prevalence of mental disorders in the South-East of Spain, one of the European regions most affected by the economic crisis: The cross-sectional PEGASUS-Murcia project. PLoS ONE, 10(9), e0137293. https://doi.org/10.1371/journal. pone.0137293
  • Puigbó, J., Edo, S., Rovira, T., Limonero, J. T., & Fernández-Castro, J. (2019). Infl uence of the perceived emotional intelligence on the coping of the daily stress. Ansiedad y Estrés, 25(1), 1-6. https://doi. org/10.1016/j.anyes.2019.01.003
  • Roca, M., Gili, M., García-García, M., Salva, J., Vives, M., García Campayo, J., & Comas, A. (2009). Prevalence and comorbidity of common mental disorders in primary care. Journal of Affective Disorders, 119(1-3), 5258. https://doi.org/10.1016/j.jad.2009.03.014
  • Ruiz-Rodríguez, P., Cano-Vindel, A., Muñoz Navarro, R., Medrano, L., Moriana, J. A., Buiza Aguado, C., … González-Blanch, C. (2017). A systematic review and critique of the economic impact and burden of common mental disorders in Spain. Ansiedad y Estrés, 23(2-3), 118123. https://doi.org/10.1016/j.anyes.2017.10.003
  • Sheehan, D. V., Harnett-Sheehan, K., & Raj, B. A. (1996). The measurement of disability. International Clinical Psychopharmacology, 11, 89-95.
  • World Health Organization (2017). Depression and other common mental disorders: Global health estimates (No. WHO/MSD/MER/2017.2). World Health Organization. https://doi.org/10.1002/mas
  • World Health Organization (2019). Disabilities. Retrieved from https:// www.who.int/topics/disabilities/en/