Screening for depression in elderly primary care patients. A comparison of the Center for Epidemiologic Studies-Depression Scale and the Geriatric Depression Scale

1997 ◽  
Vol 157 (4) ◽  
pp. 449-454 ◽  
Author(s):  
J. M. Lyness
Keyword(s):  
Primary Care ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Geriatric Depression ◽  
Primary Care Patients

scholarly journals Case-Finding for Depression in Elderly People: Balancing Ease of Administration With Validity in Varied Treatment Settings

2004 ◽  
Vol 59 (4) ◽  
pp. M378-M384 ◽  
Author(s):  
Karen Blank ◽  
Cynthia Gruman ◽  
Julie T. Robison
Keyword(s):  
Primary Care ◽  
Major Depression ◽  
Nursing Homes ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Diagnostic Interview ◽  
Case Finding ◽  
Late Life Depression ◽  
Cut Points

Abstract Background. Little is known about the performance of brief and ultrabrief (1- and 2-question) depression screens in older patients across varied treatment sites. This study (1) assesses their validity in clinics, hospitals, and nursing homes and (2) assesses cut-points for optimal clinical application. Methods. 360 patients aged 60 years and older from 2 urban primary care practices (n = 125), 1 general hospital (n = 150), and 8 nursing homes (n = 85) were assessed using the Yale 1-question screen, the 2-question instrument derived from the Primary Care Evaluation of Mental Disorders, and long and short versions of the Center for Epidemiologic Studies Depression (CES-D) scale and Geriatric Depression Scale (GDS). Sensitivity and specificity were calculated for each screen compared with the criterion standard Diagnostic Interview Schedule (DIS) depression diagnosis and receiver operating characteristic curves generated. Results. 9% of patients met DIS criteria for major depression and 7% for subsyndromal depression. Overall, the 10-item CES-D showed the best sensitivity/specificity for major depression in clinics (79%/81%) and hospitals (92%/77%), and the short GDS in nursing homes (86%/82%). Specificity of 1- and 2-question instruments was generally low. Established cut-points generally worked best for the short screens, while modifications were useful for longer versions. Conclusions. Consideration of site of use is important in selecting brief case-finding instruments for late-life depression, with the 10-item CES-D working best in medical settings and the 15-item GDS in nursing homes.

Validity of the Brazilian version of the Geriatric Depression Scale (GDS) among primary care patients

2009 ◽  
Vol 22 (1) ◽  
pp. 109-113 ◽  
Author(s):  
Milena Sampaio Castelo ◽  
João M. Coelho-Filho ◽  
André F. Carvalho ◽  
José W. O. Lima ◽  
Jamile C. S. Noleto ◽  
...  
Keyword(s):  
Primary Care ◽  
Predictive Value ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Northeastern Brazil ◽  
Geriatric Depression ◽  
Primary Care Clinics ◽  
Brazilian Version ◽  
Major Depressive Episodes ◽  
Depressive Episodes

ABSTRACTBackground: The aim of the present study was to determine the validity of the Brazilian version of the Geriatric Depression Scale (GDS) with 30 (GDS-30), 15 (GDS-15), 10 (GDS-10), 4 (GDS-4) and 1 (GDS-1) items and to calculate the optimum cutoff points for identifying depression among elderly primary care subjects.Methods: A cross-sectional study was carried out involving 220 elderly patients recruited from four primary care clinics in northeastern Brazil. The following measurements were obtained: sociodemographic variables, Katz scale of independence in activities of daily living, and the GDS with 30, 15, 10, 4 and 1 item(s). A psychiatrist blinded to the results of the GDS applied the mood module of the Structured Clinical Interview for the DSM-IV for the diagnosis of major depressive episodes as the “gold standard.”Results: The use of the cut-off point of 10/11 for the GDS-30 produced sensitivity and specificity rates of 92.0% (95% CI: 70–98) and 79% (95% CI: 73–85), respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 49% and 98%, respectively. The optimum cut-off point for the GDS-15 was 4/5, at which sensitivity was 87% (95% CI: 71–95) and specificity was 82% (95% CI: 76–91), PPV was 51% and NPV was 97%. At the cut-off point of 3/4 the sensitivity, specificity, PPV and NPV for the GDS-10 were 76% (95% CI: 60–89), 81% (95% CI: 75–87), 46% (95% CI: 33–59%), and 94% (95% CI 89–97%), respectively. The optimum cut-off point for the GDS-4 was 0/1, at which sensitivity was 84% (95% CI: 68–93%); specificity was 75% (95% CI; 68–91%); PPV was 41% and NPV was 96%. For the GDS-1, sensitivity was 47%, specificity was 96%; PPV was 69% and NPV was 90%.Conclusions: The GDS-30, GDS-15, GDS-10 and GDS-4 proved to be good screening instruments for depression in primary care clinics in Brazil, whereas the GDS-1 failed to perform adequately.

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