SUMMARYBackground In geriatric psychiatry assessment scales are often used in clinical praxis in the diagnostic work-up of mental disorders. Aim To assess whether the state part of the STAI is useful as a case-finding instrument of mental disorders. Materials and method Data came from 70 non demented geriatric in-patients in stable clinical condition. Mean age was 83.3 years (range 64-96), and 74.3% were women. The 20-item STAI state instrument was used to measure current anxiety symptoms. Without knowledge of the score on STAI state a psychiatrist examined all patients and set diagnosis according to DSM-IV-TR criteria, but hierarchical rules were not used. Sensitivity, specificity, Likelihood ratio and accuracy were calculated for different cut-points of the mean sumscore on the STAI state. Results 15.7% of the participants suffered from a mental disorder: GAD ¼ 1, mixed anxiety-depression ¼ 5, depression ¼ 1, dystymic ¼ 1, adjustment disorder (mixed anxiey-depression) ¼ 1, and personality disorder ¼ 1. The mean STAI sumscore in this group was 56.3 compared with 39.2 in the 59 patients without any psychiatric diagnosis. The optimal cut-off score on the STAI mean sumscore corresponding to the highest accuracy of 0.87 was 55/54 with sensitivity 0.82, specificity 0.88, and LR þ 6.8. Conclusion The STAI state scale is a useful instrument for detecting a variety of mental disorders in older people. Further studies should be carried out in different populations.

The prevalence of depression in the elderly is high and remains high into old age, perhaps due to increased functional disability.

Our study demonstrated high estimates where anxiety and depression occurred in parallel both as disorders and as subthreshold syndromes.

Consistent with previous estimates, depression was highly prevalent in institutions, particularly in younger individuals with severe functional impairment. Those in institutions report considerably more symptoms of depression. Finding interventions which address these symptoms might improve quality of life for people in institutions, irrespective of formal diagnoses.