Psychiatric morbidity among residents in a home for the elderly in spain: Prevalence of disorder and validity of screening

Abstract

SUMMARYAll residents in a home for elderly vcilidos (able) in Spain were interviewed and 101 completed the study. Non-medical interviewers administered the GHQ-28 items and either Zung's Self-Rating Depression Scale (SDS) (N=69) or the Geriatric Depression Rating Scale (GDS) (N=3 1). The residents were also examined blind by psychiatrists standaidized in the use of the Clinical Interview Scale (CIS), who also administered the 'Mini-Examen Cognoscitivo', the Spanish version of the Mini-Mental State Examination (MMSE), and diagnosed the identified 'cases' according to ICD-9 criteria. Twenty-one residents (20.8%) were considered to be 'cases' on the basis of the CIS; 14 (13.9%) were diagnosed as depressed and only four (4%) were diagnosed as being demented, although the mean age of the sample was 81.9 years (SD=5.6). Most 'cases' were of mild intensity and the differences with 'non-cases' seemed quantitative rather than qualitative. The GHQ-28 correctly identified 81.5% of 'cases' with a cutting score of 5 / 6 (sensitivity 70%, specificity 84.4%) and 77.4% of 'cases' with a cutting score of 4 / 5 (sensitivity 85%, specificity 75.3%), suggesting a discriminativs power almost as good as in adult individuals. In the pilot study, the GDS performed better than the SDS as a screening instrument. The addition of the 'Mini-Examen' would have improved the sensitivity of both the GHQ-28 items and the SDS.

Propiedades psicométricas de la escala geriátrica de depresión (GDS): análisis procedente de cuatro investigaciones

“…Las variables predictivas para este estudio global fueron: el grupo de pertenencia (residencias [1] y comunidad [2]), sexo (varón [1] y mujer [2]), la edad cronológica en años, cuantitativa y en categorías de 60 a 64 años [1], 65 a 69 años [2], 70 a 74 años [3], 75 a 79 años [4], 80 a 84 años [5] y 85 o más años [6]; la clase social (16) variable cuantitativa; también será tratada como variable cualitativa en categorías con cinco valores: muy alta [1]; alta [2]; media [3]; baja [4] y muy baja [5] y deterioro cognitivo (17), variable cuantitativa discreta y cualitativa para los sujetos intactos o con deterioro ausente [1] y con deterioro cognitivo leve [2].…”

“…Con una muestra de asistentes a una unidad de día, obtienen la máxima fiabilidad inter-examinadores, una consistencia interna de 0'94 y de 0'92 para las dos mitades. Algunos autores, y basándose en la habitual presencia de sintomatología depresiva en las residencias para mayores, aconsejan puntos de corte superiores en estos contextos (6,13,19). (20).…”

“…Posteriormente estos autores (5) validan la escala con un grupo de personas de la comunidad (hogares de pensionistas) y otro entre los usuarios de una unidad de día, ratificando la idoneidad del punto de corte en 14 o más respuestas significativas para indicar la presencia de sintomatología depresiva. También se ha tratado de validar con internos en residencias (6), en unidades psiquiátricas (7) y, más recientemente, con muestras de atención primaria (8).…”

Brief-Time-Series Analysis of Depressive Symptomatology in Older People

“…The inter-examiner (using assistants at a day unit) reliability was high: internal consistency of .94 and .92 (splithalf method). When administered in residential contexts, a higher cut-off point of 16 significant responses is suggested (Kongstvedt & Sime, 1992;Lobo, Ventura, & Marco, 1990;Rodríguez-Testal, 1999).…”

Factors Associated with Weight Control in Older Adults

“…The GDRS (61) is a 10-item questionnaire designed as a self-rated screening measure for depression in the elderly. It has been used effectively with normal, nondepressed samples (27,60).…”