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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Depression is a common source of distress in the elderly. Screening for depression allows for accurate diagnosis and treatment by clinicians and enables prevalence estimates to be used for monitoring morbidity and health services. A screening instrument is required that is both easily administered and has been validated among the heterogenous population of community-dwelling elderly in Israel. This study assesses the suitability of a short screening test with high face validity, the Short Geriatric Depression Scale (S-GDS), in a Jerusalem community sample (n = 285). The test yielded a 34% prevalence rate for depression, which is similar to rates found in community studies elsewhere. The screening test correctly classified 72% (95% confidence interval, 60 to 84%) of those with depression in a diagnosed subsample of 71 subjects. The specificity was only 57% (95% confidence interval, 44 to 70%) which was probably due to confounding with early dementia. The S-GDS was more likely to classify as depressed those with no formal education, those of Middle Eastern origin, and women. Higher levels of sensitivity and specificity can be obtained by calibrating, the cutoff score based on the level of education. The internal consistency of the test was adequate for the community sample as a whole, as well as among various demographic subgroups. The stability of test responses was also significant. Guidelines for the development of an instrument more appropriate for the Israeli population are suggested.
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PMID:Screening for depression among the elderly in Israel: an assessment of the Short Geriatric Depression Scale (S-GDS). 270 13

A sample of 81 elderly subjects (M age = 76 years) volunteered to take part in a study to determine whether the Geriatric Depression Scale (GDS) Short Form is an acceptable substitute for the GDS Long Form. Half of the subjects took the GDS Long Form first, and half took the GDS Short Form first. After two weeks, the subjects were given the remaining form. Although the mean scores were lower than in previous correlation studies, the results indicated that the GDS Short Form correlated significantly (r = +.66, p less than .01) with the GDS Long Form, but not highly enough to be considered an appropriate substitute.
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PMID:A correlation between the Geriatric Depression Scale long and short forms. 273 14

The Geriatric Depression Scale (GDS) has been shown to be an effective screening test for depression in selected geriatric populations. However, it has not been evaluated as a screening test for depression among elderly adults with dementia of the Alzheimer type. Over a two-year period 283 patients were seen in a geriatric assessment center and were screened for depression using the Geriatric Depression Scale. They also received a clinical psychiatric diagnosis by one of two geropsychiatrists. Patients with a Clinical Dementia Rating (CDR) of 0 (cognitively intact) (n = 70) and those with mild Alzheimer's disease (CDR of 1) (n = 72) were selected for comparison. The data were analyzed using Receiver Operating Characteristic Curves (ROCs) in order to compare the utility of the Geriatric Depression Scale in these two groups. ROC curves, which plot sensitivity against false positives, have come into increasing use as a method of examining the clinical performance of tests. The area lying beneath the curve (AUC) can be estimated and used as a quantitative measure of test performance (equivalent to the Wilcoxon rank sum). In the intact group, the Geriatric Depression Scale produced a ROC curve with an AUC of 0.85 (percent score = 1), which is significant (z = 7.28, P less than .0001). In the group composed of those with Alzheimer's disease, the Geriatric Depression Scale yielded a ROC curve with an AUC of 0.66, which was not significantly different from chance (z = 1.92, P = NS). This study provides empirical evidence that while the Geriatric Depression Scale is an accurate screening test for depression in cognitively intact geriatric populations, it does not maintain its validity in populations that contain large numbers of patients with dementia of the Alzheimer type.
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PMID:Use of the Geriatric Depression Scale in dementia of the Alzheimer type. 225 77

We compared three self-rating scales (the Geriatric Depression Scale, the Zung Scale, and the Center for Epidemiologic Studies Depression Scale) with three examiner-rating scales (the Hamilton Rating Scale, the Comprehensive Psychopathological Rating Scale-Depression, and the Cornell Scale), to see which was best for 40 elderly (mean age 80 years) stroke patients, 17 of whom were depressed according to clinical examination. External validity and concurrent validity were good for all except the Cornell Scale. Reliability (internal consistency) showed that some items were not significantly correlated, which might be explained by our selection of the patients. The Geriatric Depression Scale, the Zung Scale, and the Comprehensive Psychopathological Rating Scale-Depression had the highest sensitivity, and the Zung Scale had the highest positive predictive value (93%). With regard to internal consistency, sensitivity, and predictive value, the best self-rating scales were the Geriatric Depression and the Zung scales and the best examiner-rating scale was the Comprehensive Psychopathological Rating Scale-Depression.
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PMID:Comparison of six depression rating scales in geriatric stroke patients. 277 80

In this study the psychometric properties of the Geriatric Depression Scale (GDS) and the Zung Self-Rating Depression Scale (SDS) were evaluated and compared, using a relatively large elderly community sample. The GDS generally performed well, replicating earlier findings from a different population. Also, as hypothesized, the SDS, which has a multiple-choice format, had a higher non-completion rate than the GDS, which has a true-false format. Finally, no significant differences between the responses of young-old and old-old subjects were observed.
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PMID:Psychometric evaluation of the Geriatric Depression Scale and the Zung Self-Rating Depression Scale using an elderly community sample. 280 6

The reliability, validity, and temporal stability of the Geriatric Depression Scale (GDS) were studied in sixty-nine elderly patients who had their broken hips surgically repaired. The GDS demonstrated internal consistency reliability and concurrent validity with the Hamilton Depression Rating Scale. In addition, the GDS was stable across the hospital stay and thus appeared to be less influenced by the patients' acute health status.
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PMID:Reliability, validity, and temporal stability of the geriatric depression scale in hospitalized elderly. 280 41

Fluoxetine is a new antidepressant which enhances serotoninergic neurotransmission through potent and selective inhibition of neuronal reuptake of serotonin. Metabolism by N-desmethylation occurs in man yielding desmethylfluoxetine, which also inhibits serotonin reuptake. Both the parent compound and metabolite possess elimination half-lives of several days facilitating the maintenance of steady-state plasma concentrations during long term treatment. Fluoxetine has overall therapeutic efficacy comparable with imipramine, amitriptyline and doxepin in patients with unipolar depression treated for 5 to 6 weeks, although it may be less effective than tricyclic antidepressants in relieving sleep disorders in depressed patients. Geriatric patients also responded as well to fluoxetine as to doxepin. The symptomatic improvement in patients with unipolar depression during short term fluoxetine treatment has been satisfactorily maintained when therapy was extended for at least 6 months: the relapse rate was low and similar to that of imipramine. Preliminary data have shown that patients with bipolar depression gained similar therapeutic benefit from fluoxetine or imipramine. Other preliminary trials have indicated that fluoxetine may be useful in obsessive-compulsive disorders. Usual doses of fluoxetine cause significantly fewer anticholinergic-type side effects than tricyclic antidepressants. Nausea, nervousness and insomnia are the most frequently reported fluoxetine-related adverse effects, but these have usually not been severe. Therapeutic doses of fluoxetine do not affect cardiac conduction intervals in patients without pre-existing cardiovascular disease and fluoxetine has been relatively safe in the small number of patients who have taken overdoses. It has not been clearly established whether some types of depression may respond more readily to fluoxetine than other antidepressants, and its overall therapeutic efficacy has not been compared with other second generation antidepressants. Thus, with its different and perhaps improved side effect profile compared with older tricyclic antidepressants, fluoxetine offers properties that could be used to advantage in many patients with depression.
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PMID:Fluoxetine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in depressive illness. 287 98

Depressive symptomatology has been reported to be most prevalent over the age of 65. This study examined the effects of age (young less than or equal to 60 years, old greater than 60 years) and sex on the Beck Depression Inventory (BDI), MMPI Scale 2 (Depression), and Geriatric Depression Scale (GDS). Responses to somatic versus psychological complaints on the BDI were examined separately, and the physical malfunctioning subscale (D3) of the MMPI-2 was also evaluated. No age effects were found on any of the depression scales' total scores. On the BDI, the older group reported more somatic complaints than the younger group. Psychological complaints were reported equally for young and old groups. Women reported more depressed items on the MMPI-2 and reported a greater number of symptoms of physical malfunctioning (D3) than men for both age groups. No age by sex interaction reached significance. A report of greater physical malfunctioning (D3) was significantly associated with higher scores on all the depression scales. The increased prevalence of somatic complaints on self-report depression scales probably results in higher scores, which are misinterpreted as representing more depression in the elderly population. It is recommended that a depression scale such as the GDS, which excludes somatic items, be used to assess depression in older adults.
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PMID:Absence of depression in elderly adults. 292 76

Psychosocial studies of the elderly have been limited primarily to noninstitutionalized elderly living at home in the community. Only a few studies have explored the psychological implications of being institutionalized despite the fact that approximately 5% of the 25.6 million elderly 65 years or older in the United States reside in nursing homes (Rovner & Rabins, 1985). This correlational study was a beginning effort to investigate the relationships among depression, social support, self-esteem, and selected demographic variables in a sample of 26 institutionalized elderly individuals. The Norbeck Social Support Questionnaire (NSSQ) was used for measuring social support. The Geriatric Depression Scale (GDS) and Rosenberg's Self-Esteem Scale were used to measure depression and self-esteem respectively. The applicability of these instruments for studies of the elderly is discussed. Findings indicated that the demographic characteristics of the subjects had no significant effect on their feeling of self-esteem or depression. However, social support significantly correlated with depression and there was some indication that the type of institutional setting and frequency of religious participation also interacts with the level of depression. The article concludes with recommendations for future research.
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PMID:Social support, self-esteem, and depression in the institutionalized elderly. 292 68

Two self-rating depression scales, the Depression Factor Score derived from the SCL-90 and the Geriatric Depression Scale were administered to 220 medical geriatric in-patients, and two psychiatrists, after a clinical interview, made a diagnosis according to the DSM-III criteria for affective disorders. Eighteen patients were found to be affected by major depression, 49 by dysthymic disorder, 14 by atypical depression and 13 by an adjustment disorder with depressive mood. Women and single persons proved to be significantly more affected by depressive disturbances. The performance of both scales was good, so that they seem to be useful instruments aiding the non-specialist physician in a rapid screening procedure for the identification of depression in elderly patients with medical problems.
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PMID:Assessment of depression in an elderly medical population. 294 84


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