RESUMO
OBJECTIVE: The 15-item Geriatric Depression Scale (GDS-15) is one of the most widely used screening instruments for depression among the elderly. The aim of this study was to examine the validity and reliability of the Japanese version of the GDS-15 (GDS-15-J) in comparison with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for depression. METHODS: The study participants were 128 elderly outpatients (age range, 55 to 92 years) categorized into two groups (76 non-depressive patients, 52 depressive patients) based on the DSM-IV-TR criteria for depression. RESULTS: Logistic regression analysis showed that regardless of age and sex, the GDS-15-J score could be used to screen patients for depression (p < .001). The validity of the GDS-15-J for depression assessed against DSM-IV-TR criteria was excellent based on receiver operating characteristic analysis (optimal cutoff point: 6/7; sensitivity: .98; specificity: .86). The recommended optimal cutoff score when screening for depression is 6/7. To evaluate the constructive validity of the GDS-15-J, factor analysis was performed. Three factors were extracted. Cronbach's alpha reliability coefficient was .83 to the GDS-15-J scale, which indicated a high degree of internal consistency. CONCLUSION: The GDS-15-J is a clinically applicable screening instrument for depression. CLINICAL IMPLICATIONS: In this study this version of the GDS-15-J displayed excellent psychometric properties using a 6/7 cut off. Analyses suggest some items that might be removed in future studies of an abbreviated scale.
Assuntos
Depressão/diagnóstico , Avaliação Geriátrica/métodos , Psiquiatria Geriátrica/classificação , Escalas de Graduação Psiquiátrica/normas , Reprodutibilidade dos Testes , Idoso , Idoso de 80 Anos ou mais , Depressão/classificação , Manual Diagnóstico e Estatístico de Transtornos Mentais , Análise Fatorial , Feminino , Humanos , Japão/epidemiologia , Masculino , Programas de Rastreamento/instrumentação , Pessoa de Meia-Idade , PsicometriaRESUMO
BACKGROUND: The Geriatric Depression Scale (GDS) has been widely used for late-life depression, but it lacks validation in psychological autopsy research. This study aimed to assess the validity and establish the optimal cut-off values of the GDS-30 and the GDS-15 with proxy-based data in rural China. METHODS: We applied psychological autopsy to collect data from 242 consecutive suicide cases and 242 paired living community controls. RESULTS: Subject-proxy concordance for the GDS-30 (ICCâ¯=â¯0.590) and the GDS-15 (ICCâ¯=â¯0.539) were fair in the living controls. Based on proxy-data, we found that the suicide cases had higher scores of depression than the living controls did; the values of Cronbach's alpha demonstrated good internal consistency of the GDS-30 and the GDS-15; the Spearman correlation analysis indicated that the GDS scores were correlated with hopelessness, loneliness, and quality of life. For suicide cases, the GDS-30 showed the highest Youden's index as 34.86% with a cut-off value at 22, when its sensitivity and specificity was 0.78 and 0.56, respectively; the score of 12 on the GDS-15 showed the highest Youden's index of 31.39%, and its sensitivity and specificity was 0.74 and 0.58, respectively. LIMITATIONS: This study is limited to its generalizability to Chinese urban elderly with psychological autopsy method. CONCLUSIONS: The GDS-30 and the GDS-15 were both valid tools for measuring the severity of depressive symptoms rather than screening for major depression in psychological autopsy research in rural China. The GDS-15 can be considered as a good substitute for the GDS-30.
Assuntos
Transtorno Depressivo Maior/diagnóstico , Avaliação Geriátrica , Escalas de Graduação Psiquiátrica , Idoso , Idoso de 80 Anos ou mais , Autopsia , Estudos de Casos e Controles , China , Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Feminino , Psiquiatria Geriátrica/classificação , Humanos , Masculino , Qualidade de Vida , População Rural , Sensibilidade e EspecificidadeRESUMO
This paper presents the results of a recent review of the Australian National Sub-acute and Non-acute Patient (AN-SNAP) classification system. The AN-SNAP system was developed by the Centre for Health Service Development, University of Wollongong in 1997. The review was conducted between August 2005 and September 2006. Four clinical sub-committees comprising more than 50 clinicians from sub-acute services across New South Wales as well as representatives from Queensland and the Australian Capital Territory were established to develop a set of proposals to be considered for incorporation into Version 2 of the classification. It is proposed that the final AN-SNAP Version 2 classification will be available for implementation from 1 July 2007.
Assuntos
Assistência Ambulatorial/classificação , Grupos Diagnósticos Relacionados/classificação , Cuidado Periódico , Cuidados Semi-Intensivos/classificação , Idoso , Assistência Ambulatorial/economia , Assistência Ambulatorial/estatística & dados numéricos , Austrália , Doença Crônica/classificação , Avaliação Geriátrica/classificação , Psiquiatria Geriátrica/classificação , Humanos , New South Wales , Cuidados Paliativos/classificação , Reabilitação/classificação , Cuidados Semi-Intensivos/economia , Cuidados Semi-Intensivos/estatística & dados numéricosRESUMO
O autor faz um estudo retrospectivo sobre a nosologia das depressões, abordando especialmente a fenomenologia clássica centro-européia e sua influência sobre as demais escolas psiquiátricas. Em seguida, analisa o fato de que as depressões no idoso não diferem, em essência, das depressões do adulto, apresentando nuances particulares que merecem uma avaliação mais atenta. Finalmente, aborda as atuais classificações da nosologia internacional das depressões e as suas particularidades no idoso dando especial ênfase às depressões somatomorfas