ABSTRACT. This article reviews the significance of the Geriatric Depression Scale (GDS) to practitioners and researchers in clinical gerontology, more than 10 years after the scale was introduced to the scientific community. This report summarizes findings from the most relevant validation studies in which this selfreport for assessing depression in elderly people has been tested. Included is discussion of the use of the GDS with specific populations (elderly medical inpatients, nursing home residents, and dementia populations), with description of the scale's psychometric properties and its utility when used with them. This article also provides data on the use of the GDS from more recent studies, including additional information on psychometric properties, influence of source bias, and the international dissemination of the GDS. We conclude that the GDS is a relevant self-report for the assessment of depression in the elderly, given its advantage over other self-reports that are not as easily administered to this age group, its utility in the detection of depression, and its adequate psychometric properties. However, the GDS does not maintain its validity in demented populations because it fails to identify depression in persons with mild to moderate dementia. Finally, some suggestions for future research are made.Depression in old age is a topic that has produced a great aniount of literature that has substantially contributed to the improvement of the assessment process. The ambiguity of the definition of depression in old age, its differentiation from other disorders (e.g., dementia), and the role that other related factors play in the diagnosis (e.g., medication intake) have been identified as common problems that should be investigated. Difficulties regarding assessment procedures are as important as those previously mentioned. There is a fair amount of literature about the influence of source bias on self-report. However, the self-report (meaning source of information: self rather than informant) is more traditional at measuring depression than other assessment procedures, because the characteristics of depression are largely subjective (e.g., dysphoric mood) (Rehni, 198 8).

Familism has been pointed out as a key value in Hispanic culture that may or may not be associated with caregiver distress. Although groups included in the Hispanic identity have many common features, differences between Hispanic sub-groups in the relationship of familism with burden and depressive symptoms remain unexplored. The association of familism with burden and depressive symptomatology was examined in 48 Hispanic dementia caregivers from Los Angeles (CA, USA) and 60 from Madrid (Spain) through path analyses. Burden and depressive symptomatology were positively and significantly related in both samples. Familism was significantly correlated with lesser burden in the USA Hispanic caregiver sample, but with higher levels of depressive symptoms in the Spanish sample. Significant differences between Hispanic samples were found in the relationship between familism, burden, and depression, denoting the importance of specific cultural contexts influencing dementia caregiving in Hispanics.

This study describes a cognitive-behavioural group intervention aimed principally at the modification of dysfunctional thoughts associated with caregiving (MDTC). The efficacy of the MDTC intervention in reducing caregivers' depressive symptomatology, together with the frequency and appraisal of problem behaviours, is compared to that of a waiting-list control group (WL). Furthermore, the potential mediating role of the dysfunctional thoughts in the relationship between this intervention and caregivers' depressive symptomatology is analyzed. Of the 74 dementia caregivers who were randomized to one of two conditions (MDTC and WL), 39 completed the post-intervention assessment. Statistical analyses were performed on an intention-to-treat basis, using last observation carried forward. The results reveal that the MDTC intervention is successful in reducing caregivers' level of depressive symptomatology and dysfunctional thoughts about caregiving, as well as in modifying their appraisal of their relative's problem behaviours. Furthermore, a mediating role for dysfunctional thoughts was found in the relationship between the MDTC intervention and levels of depressive symptomatology. The relevance of addressing dysfunctional thoughts and cognitive distortions in group interventions with caregivers is highlighted.

The goals of this study were to analyse the characteristics of the phenomenon of worry in old age, to analyse differential characteristics of worry in the elderly according to severity of anxiety, and to explore the discriminative ability of different DSM-IV criteria for generalized anxiety disorder (GAD) to reveal the presence of this disorder. Starting from a randomized sample of 97 individuals, those 85 representing three levels of severity of the anxiety were retained: 74 non-clinical, four with sub-threshold anxiety and seven with GAD. They were assessed with different variables typically considered to be relevant for the analysis and characterization of worry. Results indicate that the most remarkable differences in contents of worry as a function of severity of anxiety occurred in the domains of worries about health and personal worries. Furthermore, elderly people with high levels of anxiety worry more frequently, and about more issues, and perceive less control over their worrying. Significant differences between groups in past and present orientation of worry were found. Worries were more frequent in GAD and they were oriented mainly towards the present and minor everyday problems in both GAD and non-clinical people. Moreover, worry about minor things together with the extent to which worry interferes in daily life were the best discriminant variables for GAD, being better than the core DSM-IV GAD criteria. We conclude that this pattern of results suggests that the potential of a specific worry to affect daily well-being and quality of life is strongly related to the presence of a disorder.

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The present study confirms the important role of cognitive-behavioural variables in the discrimination between older adults who suffer pain with and without symptoms of depression. Moreover, certain variables that in young adults had been seen to play a non-adaptive role, such as ignoring pain sensations, were seen to have an adaptive function in the elderly. Also, our results are in support of depression models - such as Abramson's Hopelessness Model - proposing that depression in chronic pain patients, unlike in other groups of depressed people, is characterized by absence of self-blame feelings.

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