CUREG 2.0

06. I am measuring depression using clinical scales, what are the recommendations?

Including a measure of depression in a protocol always poses an ethical problem (e.g., Clark et al., 2003; https://doi.org/10.1053/apnr.2003.50003). Researchers must therefore ensure that this measure is necessary. Depression scales (e.g., CES-D or BDI) are not diagnostic (Sheehan et al., 2013; https://dx.doi.org/10.1186%2F1472-6939-14-4) and are not designed to measure the intensity of a depressed mood. If the goal is to obtain an estimate of participants’ mood, the committee suggests using tools that specifically measure mood, such as the PANAS.

If the purpose of the research clearly justifies the use of a depression scale, it should not be used alone to suggest to participants a suspected diagnosis of depression. If a participant’s score is above the recommended cut-off, a recommendation can be made to seek advice from their physician. The committee recommends providing participants with a list of accessible centres (thus, depending on their location) and an informative brochure on depression.

The committee would like to draw the attention to the researchers regarding the risk of worrying participants without reason. It is recommended that a high criterion be used before alerting the participant. Certain scales (e.g., the CES-D) must be linked to the presence of other illnesses that may artificially increase the score on this scale.

References:

Clark, P. C., & Dunbar, S. B. (2003). Identifying possible depression in clinical research: Ethical and outcome considerations for the investigator/clinician. Applied Nursing Research, 16(1), 53-59. DOI: 10.1053/apnr.2003.50003

Sheehan, A. M., & McGee, H. (2013). Screening for depression in medical research: ethical challenges and recommendations. BMC medical ethics, 14(1), 1-4. DOI: 10.1186%2F1472-6939-14-4