Questionnaire Detects Depression in Mental Health Caregivers

Caring for a female patient who you feel may have clinical depression caused by the duties of caring for an adult family member with a serious mental illness? Now you detect their depressive thinking patterns with an eight-question diagnostic test designed by Jaclene Zauszniewski, psychiatric nurse researcher, Frances Payne Bolton School of Nursing, Case Western Reserve University.

Zauszniewski, who recently published study results in Issues in Mental Health Nursing, worked with Jane Suresky, assistant professor of nursing, to test what they call the Depressive Cognition Scale (DCS) on several populations and groups to test whether the short questionnaire and scale could detect the cognitive symptoms of early depression.

For the DCS, questions target a symptom of depression and measure negative thinking, with negative thoughts that are related to self-worth, power, and hope considered to be precursors to clinical depression development. The thought is that detecting negative thinking patters early can lead to prophylactic treatment to prevent serious depressive illness in a caregiver, as a caregiver who becomes depressed—from being under stress and encountering the stigma of having a family member with a mental illness—can impact the quality of life of both him- or herself and the patient for whom they care.

"Detecting depression early can be helpful for everyone, "Zauszniewski said.

For the study, the DCS was used to test the negative thinking patterns of 60 women—with an average age of 46 years and almost half of whom lived in the same house as the patient for whom they cared—who cared for an adult family member with such illnesses as depression, schizophrenia, or bipolar disorder.

Designed in 1995 by Zauszniewski, the DCS was meant to detect depressive thoughts in the elderly and is based on developmental psychologist Erik Erikson’s eight stages of human development that lead to building character strengths.

“The successful completion of each stage of life identified by Erikson from birth through old age helps individuals develop and master characteristics that allow them to function and have healthy relationships with other people,” Zauszniewski said. “On the other hand, less than successful resolution of a developmental stage, can result in the evolution of unfavorable characteristics, such as depressive thought patterns.”

In the current study DCS was found valid for diagnosing depressive thoughts in both the elderly and young through their responses to questions about their sense of purposelessness, meaninglessness, emptiness, helplessness, hopelessness, powerlessness, loneliness, and worthlessness. The test was also validated in people in cultures that speak Arabic, Portuguese, and Chinese languages.

Is the DCS worth looking into for use in your patients? Could such a simple test really help detect the precursors of clinical depression?