Accuracy of three depression screening scales to diagnose major depressive episodes in older adults without neurocognitive disorders

Costa, Mônica Vieira; Diniz, Maíssa Ferreira; Nascimento, Kenia Kelly Fiaux do; Pereira, Kelly Silva; Dias, Natália Silva; Malloy-Diniz, Leandro Fernandes; Diniz, Breno S.

doi:10.1590/1516-4446-2015-1818

Cited by 37 publications

(27 citation statements)

References 16 publications

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“…The positive correlation confirmed the instrument's ability to discriminate levels of MDD in comparison with HDRS scores. Similar results were consistently reported in the literature with diverse populations [64] but this is the first study reporting this validity in patients with epilepsy in sub-Saharan Africa.…”

Section: Plos Onesupporting

confidence: 91%

Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda

et al. 2020

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Background Patients with epilepsy (PwE) have an increased risk of active and lifetime depression. Two in 10 patients experience depression. Lack of trained psychiatric staff in low-and middleincome countries (LMIC) creates a need for screening tools that enable detection of depression in PwE. We describe the translation, validity and reliability assessment of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for depression among PwE in Rwanda. Method PHQ-9 was translated to Kinyarwanda using translation-back translation and validated by a discussion group. For validation, PwE of �15 years of age were administered the PHQ-9 and Hamilton Depression Rating Scale (HDRS) by trained psychiatry staff at Visit 1. A random sample of 20% repeated PHQ-9 and HDRS after 14 days to assess temporal stability and intra-rater reliability. Internal structure, reliability and external validity were assessed using confirmatory factor analysis, reliability coefficients and HDRS-correlation, respectively. Maximal Youden's index was considered for cutoffs. Results Four hundred and thirty-four PwE, mean age 30.5 years (SD ±13.3), were included of whom 33.6%, 37.9%, 13.4%, and 15.1% had no, mild, moderate and severe depression, respectively. PHQ-9 performed well on a one-factor model (unidimensional model), with factor loadings of 0.63-0.86. Reliability coefficients above 0.80 indicated strong internal consistency. Good temporal stability was observed (0.79 [95% CI: 0.68-0.87]). A strong correlation (R = 0.66, p = 0.01) between PHQ-9 and HDRS summed scores demonstrated robust

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Section: Plos Onesupporting

confidence: 91%

Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda

et al. 2020

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“…In comparison, other authors (Costa et al, 2016) affirmed that in older adults without neurocognitive disorders the cut-off of 6 should be used for purposes of depression detection. The mean age of participants included in this last study was of 71 years.…”

Section: Discussionmentioning

confidence: 97%

Exploring a capacity to screen of the European Portuguese version of the 15-item Geriatric Depression Scale

Apóstolo

Bobrowicz-Campos

Reis³

et al. 2018

RPPC

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Abstract:The aim of this study was to analyze the screening performance of the European Portuguese version of the 15-item Geriatric Depression Scale (GDS-15) against DSM-5 diagnostic criteria for major depressive episode. The study was multicentre and involved 139 older adults recruited in the context of primary healthcare. Twenty-three participants were diagnosed with clinical depression. Sensitivity and specificity for different cut-off points were determined based on ROC curve analyses. The cut-off point ≥ 4.5 provided optimal sensitivity (95.7%) and specificity (52.6%) rates. After exclusion from the analysis of illiterate participants' data, the optimal cut-off point remained unchanged. The European Portuguese version of GDS-15 is an effective tool for depression screening in older adults. Further studies are needed to verify if there are factors, other than formal education, that may influence the scale's performance.Keywords: Depression; Geriatric Depression Scale; older adults; screening. Exploración de la capacidad de screening de la versión europea portuguesa de la Geriatric Depression Scale de 15 itemsResumen: El objetivo del estudio fue comparar la capacidad de cribado de la versión europea portuguesa de la Geriatric Depression Scale de 15 ítems (GDS-15) respecto a los criterios del DSM-5 en relación con el trastorno depresivo mayor. El estudio fue multicéntrico e incluyó 139 ancianos (23 con diagnóstico de depresión) reclutados en un contexto de atención primaria. La sensibilidad y la especificidad para diferentes puntos de corte fueron obtenidas a través de curvas ROC. La relación de sensibilidad y especificidad reveló ser mejor en el punto de corte ≥ 4.5, resultante en sensibilidad del 95.7% y especificidad del 52.6%. Después de excluirse del análisis de los datos los participantes sin educación formal, el punto de corte óptimo permaneció sin cambios. La versión europea portuguesa de la escala GDS-15 es una herramienta efectiva para el screening de la depresión en ancianos. Se necesitan más estudios para verificar si hay otros factores que puedan influir en el rendimiento de la escala.

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“…The reason why mild depressive symptoms (defined as a GDS score of 2‐5) remain associated with healthcare costs and utilization, even after accounting for multimorbidity and functional limitations, is uncertain. While some individuals with clinically diagnosed major depression may score below 6 on the GDS, the negative predictive value of a GDS score below 6 for the absence of major depression by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM‐IV ), criteria is over 90% . Thus, it is highly unlikely clinical depression within this subset could explain our findings.…”

Section: Discussionmentioning

confidence: 78%

Depressive Symptoms and Total Healthcare Costs: Roles of Functional Limitations and Multimorbidity

Schousboe

Kats

et al. 2019

J American Geriatrics Society

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OBJECTIVES Depressive symptoms can be both a cause and a consequence of functional limitations and medical conditions. Our objectives were to determine the association of depressive symptoms with subsequent total healthcare costs in older women after accounting for functional limitations and multimorbidity. DESIGN Prospective cohort study (Study of Osteoporotic Fractures [SOF]). SETTING Four US sites. PARTICIPANTS A total of 2508 community‐dwelling women (mean age = 79.4 years) participating in the SOF year 10 (Y10) examination linked with their Medicare claims data. MEASUREMENTS At Y10, depressive symptoms were measured using the 15‐item Geriatric Depression Scale (GDS) and functional limitations were assessed by number (range = 0‐5) of impairments in performing instrumental activities of daily living. Multimorbidity was ascertained by the Elixhauser method using claims data for the 12 months preceding the Y10 examination. Total direct healthcare costs, outpatient costs, acute hospital stays, and skilled nursing facility during the 12 months following the Y10 examination were ascertained from claims data. RESULTS Annualized mean (SD) total healthcare costs were $4654 ($9075) in those with little or no depressive symptoms (GDS score = 0‐1), $7871 ($14 534) in those with mild depressive symptoms (GDS score = 2‐5), and $9010 ($15 578) in those with moderate to severe depressive symptoms (GDS score = 6 or more). After adjustment for age, site, self‐reported functional limitations, and multimorbidity, the magnitudes of these incremental costs were partially attenuated (cost ratio = 1.34 [95% confidence interval {CI} = 1.14‐1.59] for those with mild depressive symptoms, and cost ratio = 1.29 [95% CI = 0.99‐1.69] for those with moderate to severe depressive symptoms vs women with little or no depressive symptoms). CONCLUSION Depressive symptoms were associated with higher subsequent healthcare costs attributable, in part, to greater functional limitations and multimorbidity among those with symptoms. Importantly, even mild depressive symptoms were associated with higher healthcare costs. J Am Geriatr Soc 67:1596–1603, 2019

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Accuracy of three depression screening scales to diagnose major depressive episodes in older adults without neurocognitive disorders

Cited by 37 publications

References 16 publications

Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda

Validity, reliability and cut-offs of the Patient Health Questionnaire-9 as a screening tool for depression among patients living with epilepsy in Rwanda

Exploring a capacity to screen of the European Portuguese version of the 15-item Geriatric Depression Scale

Depressive Symptoms and Total Healthcare Costs: Roles of Functional Limitations and Multimorbidity

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