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Screening for depression in the older long-term unemployed

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Abstract

Background

Misdiagnosis and undertreatment of depression in older, long-term unemployed people may not only pose a serious medical problem, but may also be an obstacle for their vocational reintegration. Screening for depression could be a first step to increasing treatment rates within this high-risk group. Therefore, the WHO-5 Well-Being Index was tested for its validity in unemployment offices.

Methodology

Three hundred and sixty-five participants in a German programme for the vocational reintegration of long-term unemployed people were screened with the WHO-5 Well-Being Index. In 104 of these subjects, ICD-10 diagnoses were made using DIA-X Structured Clinical Interview.

Results

Using the DIA-X data as a gold standard, the WHO-5 Well-Being Index obtained satisfactory results for sensitivity (82.5%) and specificity (70.3%) as a screening tool for affective disorders when used with an adjusted cut-off-point of ≤12. While none of the 18.5% male participants diagnosed with major depression received treatment, half of the 24% of female participants with major depression received treatment.

Conclusion

Screening with the WHO-5 within unemployment offices is useful to detect people with depressive disorders. Many of them do not receive optimal treatment and can be motivated to seek professional help. Reducing depression by better treatment will also increase the chances of reemployment.

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Authors and Affiliations

  1. Dept. of Psychiatry, Ludwig-Maximilian-University Munich, Nussbaumstraße 7, 80336, Munich, Germany

    Iris Liwowsky

  2. Dept. of Psychiatry, University Leipzig, Leipzig, Germany

    Dietmar Kramer, Roland Mergl PhD, Anke Bramesfeld MD & Ulrich Hegerl MD

  3. Dept. of Child and Adolescent Psychiatry, Ludwig-Maximilian-University Munich, Munich, Germany

    Antje-Kathrin Allgaier PhD

  4. Institute for Medical Psychology, Ludwig-Maximilian-University Munich, Munich, Germany

    Ernst Pöppel MD

Authors
  1. Iris Liwowsky
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  2. Dietmar Kramer
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  3. Roland Mergl PhD
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  4. Anke Bramesfeld MD
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  5. Antje-Kathrin Allgaier PhD
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  6. Ernst Pöppel MD
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  7. Ulrich Hegerl MD
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Correspondence to Iris Liwowsky.

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Liwowsky, I., Kramer, D., Mergl, R. et al. Screening for depression in the older long-term unemployed. Soc Psychiat Epidemiol 44, 622–627 (2009). https://doi.org/10.1007/s00127-008-0478-y

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  • DOI: https://doi.org/10.1007/s00127-008-0478-y

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