Depression is considered one of the leading causes of health disorders and mortality after cardiovascular diseases (Kerr & Kerr, 2001). Researchers suggest that depression will become the “leading cause of disability and the second leading contributor to the global burden of disease by 2020” (Kerr & Kerr, 2001). Screening remains one of the most reliable and cost-effective tools for identifying the symptoms of depression and developing preventive measures. Self-reporting screening tools provide healthcare providers with the reliable primary information and determine the direction of further treatment.
Self-reporting screening tools have already proved to be effective methods of identifying the symptoms of depression across different population layers; self-reporting is a reliable means of identifying the symptoms of depression when it accompanies other complex medical states (e. g. , terminal cancer). In a physical therapy unit, self-reporting is likely to provide medical personnel with the set of simple and informative procedures that will help identify depression at its initial stages, and develop a set of preventive measures to address mental health issues.
Kirchner (1998) was researching the effectiveness of one item and two-item self-reporting instruments for screening depression: the author has concluded that “a single-item interview that simply asks “Are you depressed? ” provides a very reliable and accurate screening tool when assessing depressed mood in terminally ill patients”. The extension of the screening tool and the inclusion of other screening elements (e. g. the loss of interest in activities) did not improve the accuracy of the screening procedure.
Sharp and Lipsky (2002) support this viewpoint, and add that “self-reporting measures can be quickly completed and scored, although other time-intensive, interviewer-administered measures may be necessary when patients are cognitively impaired”. Sharp and Lipsky (2002) suggest that in physical therapy clinical setting, the patient’s scoring above the self-reporting cutoff level should be further diagnosed according to DSM-IV-TR criteria. It should be noted that physicians are recommended to stay alert in terms of depression symptoms in patients (Kerr ; Kerr, 2001).
The accuracy of the screening tool is critical for the identification of primary depression symptoms. Kerr and Kerr (2001) and Kirchner (1998) address the challenges physical therapy providers should address to ensure that the self-reporting screening tool is accurate and reliable. “A patient’s culture, gender, and/ or predominance of somatic symptoms can impede the detection of depression” (Kerr ; Kerr, 2001). Gender bias is one of the most serious obstacles against effective use of self-reporting screening tools for depression.
Professionals should be aware of cultural peculiarities and their impact on the results of self-reporting screening. Kerr and Kerr (2001) offer a set of examples that prove the relevance of cultural and ethnic background to the effectiveness of self-reporting techniques; furthermore, the authors suggest that “social norms may contribute to the implicit prohibition of certain self-descriptive terms depending on a patient’s gender” (Kerr ; Kerr, 2001).
This opinion is supported by Kirchner (1998) in that “the reliability of a depression screening tool is affected by patient’s interpretation of its emotional terms and their cultural conception of depression”. Sharp and Lipsky (2002) support this idea stating that “depression screening measures should be selected based on the patient population”. However, none of the authors doubts the relevance of self-reporting tools in physical care clinical setting.
Self-reporting tools are reliable sources of primary health information. Self-reporting questionnaires are extremely effective for identifying the symptoms and addressing depression issues among terminally ill patients. To guarantee accuracy of self-reporting results, physical therapy providers should avoid gender and cultural bias, and should pay more attention to the way the patient interprets his health state. The choice of self-reporting techniques should be based on the population group which is being screened for depression.