Objective: There are many well established screening instruments for the detection of depression in community-based samples. This study focuses on the ability of such instruments to detect subthreshold symptoms of depression and anxiety in the elderly general population. Methods: The diagnoses of subthreshold depressive disorders, subthreshold generalized anxiety disorder, and subthreshold panic disorder were made according to the criteria proposed by Angst. Additionally, we included subthreshold agoraphobia, subthreshold social phobia, and subthreshold specific phobia to the category of subthreshold anxiety disorders. The study was carried out on 287 subjects out of the general population aged 60-99 years. All subjects completed the short version of the General Health Questionnaire (GHQ-12) and the Center for Epidemiologic Studies-Depression Scale (CES-D). The perfomance of the questionnaires was assessed by receiver operating characteristics (ROC) analysis. Results: Both the GHQ-12 and the CES-D discriminated between the presence and the absence of subthreshold disorders, however their performance was poor. Items describing somatic/vegetative complaints showed the highest discriminating ability. Conclusions: Subthreshold disorders in elderly subjects can be identified by using well-established screening instruments, however modifications ofthese instruments should be undertaken to improve sensitivity and specificity. We suggest the inclusion of more items describing somatic complaints to reach better performance.
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