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

The authors present a contribution to the french validation of the self-rating questionnaire of the depression in the elderly proposed by Yesavage and Brink (1982), the Geriatric Depression Scale (30 items). This study focusses on the assessment of the homogeneity and of the unidimensionality of this scale. 99 aged women living in old-people homes or attending a geriatric somatic day-hospital, not known to be psychiatrically ill, filled the GDS and were interviewed by either a psychiatrist or by a clinical psychologist. This interview yielded 44 cases of Major Depressive Disorder or of Dysthymia (DSM III). Firstly, we have applied the classical correlational methods of assessment of scale Reliability and Construct Validity: Cronbach's coefficient alpha and item-total correlations (homogeneity) and Principal Component Analysis (PCA) without rotation. Then, we have performed a Rasch Model Analysis: this method which belongs to the general frame of Latent Trait Theory relies on a probabilistic model of subject's response to individual questions. In the Rasch model, the response probability of a given subject to a given item is a logistic function of the difference between the item location parameter and the subject location parameter along a single continuous latent dimension. Our results have shown that the Cronbach's alpha was very high (.902) and that the item-total correlations were quite satisfactory (mean .470), thus giving a strong impression of homogeneity (similar to unidimensionality for many authors).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Study of the uni-dimensionality of the Yesavage-Brinck geriatric depression scale. Comparison between classical methods and Rasch's model]. 827 98

The prevalence of depression in the elderly was investigated in a random stratified sample of 100 subjects from the general population of Appignano (Macerata, Regione Marche, Italy). After sampling with the simple random method, each subject underwent a diagnostic work-up including: a) three psychodiagnostic tests (Short Scale for the Assessment of Mental Health--SSAMH, Geriatric Depression Scale--GDS, and Scale for the Self-evaluation of Depression from the Psychogeriatric Interview--PGI) and b) psychiatric evaluation (according to DSM-III-R diagnostic criteria). Results were as follows: a) all the 3 tests (SSAMH, GDS, PGI) were suitable for the goals of this research, with a sensibility of 95.4%, 90.9%, and 95.4%, and a specificity of 90.4%, 88.9%, and 90.5%, respectively; b) the prevalence of depression in the sample was 25.9% (26.1% in females and 25.6% in males); c) the most common disorder was dysthymia, with higher percentage in females than in males (75% and 50% of all the depressive syndromes, respectively); d) the prevalence of depression was higher in females 60-69 years old and in males 70-79 years old.
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PMID:[Clinical investigation on depression on a randomized and stratified sample in an elderly population]. 174 52

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

This paper describes the design and first results of the cross-sectional phase of a study on memory impairment in elderly subjects (Pavia Memory Project). The target population consisted of the 1,046 subjects born in 1925 and currently living in Pavia. Four hundred and thirty-six subjects (plus 287 interviewed at home) participated in the first stage, which consisted of a semi-structured anamnestic interview. The 400 interviewed subjects with none of the exclusion criteria participated in the second stage, which consisted of a memory test battery, a standardized neurological examination and screening procedures for depression (GDS) and dementia (MMSE). On the basis of the memory scores, three groups were defined: memory impairment (MI: 8.8%), mild memory impairment (MMI: 39.8%); normal (N: 51.3%). There were more failures on the visuo-spatial memory tests. Depression was equally distributed in the N and MI groups (about 15%), but was more frequent in the MMI group (27%). Abnormal neurological signs were largely independent of memory performance. Two cohorts (of MI and N subjects) underwent neuropsychological and instrumental (CT-scan, EEG, ERPs, eye movements) assessment, which will be regularly repeated in the longitudinal phase.
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PMID:Pavia memory project: study design and first results. 755 67

Depression has been a significant problem in the elderly. The purposes of this study were to determine the incidence of depression in elderly clients who are homebound and to investigate whether home healthcare nurses make depression-related nursing diagnoses. The Geriatric Depression Scale was done on 40 subjects from an urban home health agency. Results of the study showed that although 27.5% of the subjects scored in the depressed range on the GDS, home health nurses failed 100% of the time to document any depression-related nursing diagnoses.
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PMID:Depression. The missing diagnosis in the elderly. 759 21

Evaluation of the relative efficacy of three screening instruments for depression and anxiety in a group of stroke patients was undertaken as part of the Perth community stroke study. Data are presented on the sensitivity and specificity of the Hospital Anxiety and Depression Scale (HAPS), the Geriatric Depression Scale and the General Health Questionnaire (GHQ) (28-item version) in screening patients 4 months after stroke for depressive and anxiety disorders diagnosed according to DSM-III criteria. The GHQ-28 and GDS but not the HADS depression, were shown to be satisfactory screening instruments for depression, with the GHQ-28 having an overall superiority. The performance of all 3 scales for screening post-stroke anxiety disorders was less satisfactory. The HADS anxiety had the best level of sensitivity, but the specificity and positive predictive values were low and the misclassification rate high.
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PMID:Screening instruments for depression and anxiety following stroke: experience in the Perth community stroke study. 762 7

Depression in the elderly is frequent but often unknown (in 30 to 50% of the cases) because of difficulties in detecting or diagnosing it. This is due to the clinical features and prognosis of depression in this kind of population but also to the non-existence of specific diagnostic tests. Most of the authors consider that the most useful diagnostic tests are screening assessments. Some are rating scales that have been validated in general population then secondarily in the elderly: Hamilton Rating Depression Scale (HDRS), Montgomery & Asberg Depression Rating Scale (MADRS), Zung Self Rating Depression Scale (Zung SDS), Beck Depression Inventory (BDI) or Center for Epidemiological Studies Depression Scale (CES-D). They usually involve biases linked to age and more particularly to somatic items; and the educational level required to answer is too high for this population. However, the MADRS is still interesting for measuring change under treatment and the CES-D for detection of depressive elderly. On the other hand, some screening scales are specific of depression in the elderly. The most commonly used is the GDS (Geriatric Depression Scale) with 30 items. Some points have been discussed to increase the achievement of these methods. For example, inventories are better than interviews and should be integrated into semi-standardized interviews which do not last more than 30 minutes. The quotation 'yes' or 'no' is preferable. The instrument have to be short but have to contain specific items for depression in the elderly. Several short forms are already validated or in progress such as GDS with 15 items and, recently, with 4 items, BASDEC, short Zung IDS, BDI with 13 items and DGDS. However, these screening scales loose a part of their validity in the moderate or severe demented elderly. Few instruments can screen depression in a demented population although depression and dementia syndromes are frequently associated. Some of the inventories used are not specific: they evaluate the general psychopathology in the elderly and contains subscales which screen depression or organic brain disease. Thus, GMS-AGECAT Package, CAMDEX, CARPER, BAS are often used by the Anglo-Saxons. At present, only one specific instrument has been validated: the Cornell Scale for Depression in Dementia. Recently, new screening instruments have been put forward: Dementia Mood Assessment Scale and Canberra Interview for the elderly which seem interesting but need further studies.
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PMID:[Psychometric evaluation of depression in the elderly subject: which instruments? What are the future perspectives?]. 772 Jun 19

The relationship between depression and cognition in older adults has become a topic of extensive research and clinical interest. Results of previous research are limited, however, by sampling and methodological problems. Small sample sizes and the treatment of depression as a dichotomous variable may be major factors that limit data interpretation in previous studies. The present sample of 220 geriatric medical patients was split into a validation and a cross-validation sample specifically to test the hypothesis that depression is an independent predictor of cognition. Multiple regression analyses, controlling for the direct effects of demographic factors, found that Geriatric Depression Scale scores were consistently a significant predictor of Dementia Rating Scale and Logical Memory scores. Overall, GDS scores accounted for approximately 8% of unique variance for both measures of cognition. Demographic factors, particularly age and race, were also significant predictors of cognitive test scores. These data were interpreted as providing support for the hypothesis that level of depression predicts level of cognitive functioning.
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PMID:The relationship between depression and cognition in older adults: a cross-validation study. 775 20

One-hundred and ninety-eight elderly subjects attending their general practitioners (GPs) were asked to complete the 15 item Geriatric Depression Scale (GDS15). Analysable results were obtained from 194 (98%). Of these, 67 (34%) scored above the GDS15 cut-off (4/5) for significant depressive symptomatology. 87.6% found the questionnaire to be acceptable and only 3.6% found it very difficult or very stressful. The GDS15 had a high level of internal consistency (Cronbach's alpha = 0.80). All the individual items of the GDS15 associated significantly (P < 0.01) with total score and 'caseness'. A single question "do you feel that your life is empty?" identified 84% of 'cases'. In an attempt to devise short scales to screen elderly primary care patients for depression, the data were subjected to logistic regression analysis. Ten (GDS10), four (GDS4) and on (GDS1) item versions were generated. Agreement between these short scales and the GDS15 in the original sample was 95, 91 and 79% respectively. Cronbach's alpha was 0.72 for the GDS10 and 0.55 for the GDS4. The short scales were then validated in an independent sample of 120 patients in whom both GDS data and the results of a detailed psychiatric interview (the Geriatric Mental Status Schedule, GMS) were available. The sensitivity and specificity of the GDS10 against GMS caseness were 87 and 77% (cut-off 3/4); those of the GDS4 were 89 and 65% (cut-off 0/1) and 61 and 81% (cut-off 1/2). Sensitivity and specificity for the GDS1 were 59 and 75%. It is concluded that these short scales may be useful in helping GPs and practice staff to identify elderly patients with significant depressive symptoms.
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PMID:Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. 784 14

Case note data were obtained for 186 elderly primary care attenders who also completed the 15 item Geriatric Depression Scale (GDS15). The presence or absence in the case notes of a current or past diagnosis of depression, of current treatment of depression, and of a number of clinical features of depression were noted. Case notes were also rated for the presence or absence of contraindications to the use of tricyclic antidepressants (TCAs) and to serotonin-specific reuptake inhibitors (SSRIs). Whereas 65 (35%) patients were rated as 'cases' of depression on the GDS15, only 28 (15%) had a current case note diagnosis of depression and 37 (20%) had one or more current symptoms of depression recorded in the case notes. Patients rated by their GP as having one or more current symptoms of depression scored higher on the GDS15 (P < 0.05) and were more likely to be categorized as a GDS case (P = 0.05). There was no significant relationship between GDS caseness and a current case note diagnosis of depression. Seventy-three patients (39%) had a past history of depression and 53 (28.5%) patients had previously been treated with antidepressants. The former was significantly associated with GDS caseness (P < 0.05). Twenty-four patients (13%) were currently on antidepressants, 19 of them receiving adequate doses (equivalent to at least 75 mg of amitriptyline). Current antidepressant treatment was not associated with GDS 'caseness'.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Screening, detection and management of depression in elderly primary care attenders. II: Detection and fitness for treatment: a case record study. 784 15


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