Single-item depression screening with the Neurobehavioral Symptom Inventory (NSI): Do scores assist clinicians with predicting need for mental health interventions?

The purpose of this study was to examine the relationship between a single item for depression from the Neurobehavioral Symptom Inventory (NSI) and a common depression screening measure to predict need for further mental health consultation for veterans with traumatic brain injury (TBI). Three hundred eighty veterans referred to a Veterans Affairs Health Care System TBI clinic for evaluation were administered the NSI and a common depression screening measure (Beck Depression Inventory-Second Edition; BDI-II). Receiver Operating Characteristic (ROC) curve analyses were conducted to determine best cutoff scores on the BDI-II corresponding with a single item of the NSI item pertaining to depression (i.e., "depressed or sad"). Using multiclass ROC curve analyses, results suggested that a minimum score of 3 (severe) on the specific NSI item indicated need for further mental health referral without warranting additional screening for depression. Analyses further demonstrated that removal of invalid NSI protocols did not significantly change ROC curve findings. Therefore, the NSI item for depression can still be used for making clinical decisions despite the protocol being considered otherwise invalid. Implications for treatment and recommendations for screening are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).