Validity of a Brazilian Version of the Older Americans Resources and Services (OARS) Mental Health Screening Questionnaire

Abstract

A validity study of the Brazilian version of the 15-item Short Psychiatric Evaluation Schedule (SPES), included in the mental health assessment of Older Americans Resources and Services (OARS), designed to detect psychiatric disorders in the elderly, against the "caseness" criterion suggested by Cooper and Schwarz was carried out with a community sample, as part of a survey to study health and living conditions of the elderly in a large urban center of a developing country, São Paulo, Brazil. The screening questionnaire was completed by 292 subjects, and 91 were selected for the psychiatric interview. The validity coefficients were as follows: sensitivity 61%, specificity 89%, positive predictive value 66%, negative predictive value 87% and misclassification rate 18%. A discriminant analysis using a stepwise procedure was then applied to select the best item discriminators of the screening questionnaire. The best set of discrimination comprised six items leading to the following validity coefficients: sensitivity 82%, specificity 77%, positive predictive value 58%, negative predictive value 92% and misclassification rate 21%. The possible factors related to false positive and false negative responses on the screening are discussed.

Fatores associados à sintomatologia depressiva numa coorte urbana de idosos

“…Tal instrumento apresenta a vantagem de ser validado para a língua portuguesa (Blay et al, 1988), além de ser relativamente curto e de fácil treinamento. Por meio de 15 questões objetivas e diretas, explora o prazer da vida, a dificulda-…”

“…Para o diagnóstico de depressão, além dos critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, 4 a edição -DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) e da CID-10 (Décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde), há os instrumentos de avaliação/rastreio de saúde mental, como o SPES (Short Psychiatric Evaluation Schedule) validado para a língua portuguesa (Blay et al, 1988), e a Escala de Depressão em Geriatria -Geriatric Depression Scale, GDS (Yesavage et al, 1982). Tais instrumentos estão sendo largamente utilizados e aperfeiçoados por pesquisadores como um meio de estudar e quantificar melhor os sintomas depressivos e as doenças mentais.…”

Two-year follow-up study of elderly residents in S. Paulo, Brazil: methodology and preliminary results

“…The instrument yielded information on sociodemographic characteristics, informal support, independence in daily living, chronic illnesses, mental health status, cognitive status and self-perception of health. Some key variables were selected to give a general profile regarding the main dimensions of interest in the global assessment: a) the sociodemographic variables selected were age, gender, civil state, level of education, and per capita income in the household (U$$/month); b) for a proxy of informal support available, the household structure, a variable that has been shown to be strongly associated with the functional capacity of the elderly 24 was chosen, thus identifying those living alone or with others, and expressed in terms of the number of generations cohabiting -none (alone), one (spouse, next of kin), two (children), and three (grandchildren); c) independence in daily living was analyzed based on the number of activities of daily living (ADLs) requiring assistance to be performed, from a checklist of 15 ADLs (shopping, getting public transport, caring for the finances, taking medicines, walking a short distance, remaining continent, dressing, going to the toilet, grooming, cutting toe nails, bathing, eating, getting in and out of bed), using a previously validated hierarchical model of the ADLs 26 ; d) chronic illnesses were expressed by an ordinary score of the referred health problems out of a checklist of 10 (rheumatism; asthma; high blood pressure; varicose veins; diabetes; obesity; stroke history; urinary incontinence; constipation; sleeping problems; cataract; back pain); e) mental health was evaluated based on a screening, that has been validated for use among elderly residents in S. Paulo 5 , that identifies probable cases of psychiatric disturbance; e) cognitive status was assessed by the Mini Mental State Examination (MMSE) 12 , an instrument widely used for this purpose with a standard cutoff point of 24 points (a score of 23 or less will indicate cognitive impairment) 6 ; f) finally, the elderly's self perception of health was based on the question "how would you rate your own health?" (excellent/good/poor/bad) (Figure 2a).…”

Frequency of Werner helicase 1367 polymorphism and age-related morbidity in an elderly Brazilian population

“…An MMSE score lower than 24 (out of 30) has 80-90% sensitivity and 80% specificity for discriminating individuals with low cognition level (roughly classified as dementia) from normal subjects (22,23). Depression was characterized by a score above 5 in a validated Brazilian version of the Older American's Resources and Services questionnaire (24).…”