Agreement in Depression Determination among Four Self-Rating Depression Scales Applied to Japanese Community-Dwelling Elderly

ABSTRACT

Objective: In this study, we examined the characteristics of depression determination using four representative self-rating depression scales (Geriatric Depression Scale, GDS; Self-rating Depression Scale, SDS; Center for Epidemiologic Studies Depression Scale, CES-D; and Carroll Rating Scale, CRS) applied to Japanese community-dwelling elderly. Methods: Subjects were 563 community-dwelling independent elderly living in twelve prefectures (330 males, 68.9±6.3 yr; 233 females, 68.1±5.8 yr). Results: Depression rates determined using SDS (45.8%) and CES-D (68.6%) were higher than those determined using GDS (5.7%) and CRS (14.7%). Although correlations of depression scale scores among the four scales were significant and comparable (r: 0.61 (GDS vs. SDS, p<0.01) to 0.78 (SDS vs. CES-D, p<0.01)), the agreement in depression determination varied among scales (kappa coefficients: 0.05 (GDS vs. CES-D, p>0.05) to 0.46 (SDS vs. CES-D, p<0.01)). Conclusions: Similarities in depression determination were found between GDS and CRS, and between CES-D and SDS. Depression rates determined on the basis of cut-off point for each scale were higher for CES-D and SDS than for GDS and CRS. Depression determination using a four-point rating scale may overestimate a slightly depressive symptom, compared with that using a two-point scale.