Table 2.

Scales assessing depression in MS patients.

	BDI	HADS	PHQ-9	CES-D
Self-administered	Yes	Yes	No	Yes
Assesses	Clinical symptoms of melancholia Intrusive thoughts	Anxiety Depression	Depressive symptoms present in the last 2 weeks	Depressive symptoms present in the last week
Cut-off points	0-13: minimum depression 14-19: mild depression 20-28: moderate depression 29-63: severe depression	The score range is 0-21 for each subscale, and 0-42 for the overall score. A score of ≥ 11 in a subscale suggests that there might be a clinical problem	The range of scores is 0-27 and each item ranges from 0 (never) to 3 (more than half the days)	Major depressive episode: anhedonia or dysphoria nearly every day for the past 2 weeks, plus symptoms in an additional 4 DSM symptom groups noted as occurring nearly every day for the past 2 weeks
Advantages	Has the highest percentage of cognitive symptoms present, emphasizing the absence of motor symptoms and anxiety	Suppression of somatic symptoms: depression can be evaluated independently of the underlying somatic disease	A short version has been proposed using two screening questions for the detection of major depressive disorders in the context of MS and primary care (PHQ-2) corresponding to depressed mood (“during the last 2 weeks, have you felt down, depressed, or hopeless?“) and anhedonia (“have you felt little interest or pleasure in doing things for the past 2 weeks?“)	Very brief scale, no trained staff is needed
Validated in MS?	No	Yes	Yes	Yes
		Scores on the depression subscale ≥ 8 have shown a sensitivity of 85% and a specificity of 82.2%	Scores ≥ 10 have shown a sensitivity of 95% and a specificity of 85.9%	Scores ≥ 16 have shown a sensitivity of 94.7% and a specificity of 73.1%

BDI, Beck Depression Inventory; HADS, Hospital Anxiety and Depression Scale; PHQ-9, Patient Health Questionnaire, CES-D, Center for Epidemiologic Studies Depression Rating Scale.