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Validity of the five-item WHO Well-Being Index (WHO-5) in an elderly population

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Abstract

Background Depression has a high prevalence in the elderly population; however it often remains undetected. The WHO 5-item Well-Being Index (WHO-5) is a short screening instrument for the detection of depression in the general population, which has not yet been evaluated. The goals of the present study were: 1) to assess the internal and external validity of WHO-5 and 2) to compare the two recent versions of WHO-5.Study population and methods 367 subjects above 50 years of age were examined with the WHO-5. ICD-10 diagnoses were made using a structured interview (CIDI). The internal validity of the well-being index was evaluated by calculating Loevinger’s and Mokken’s homogeneity coefficients. External validity for detection of depression was evaluated by ROC analysis.Results The scale was sufficiently homogeneous (Loevinger’s coefficient: version 1=0.38, version 2=0.47; Mokken coefficient τ; 0.3 in nearly all items). ROC analysis showed that both versions adequately detected depression. Version 1 additionally detected anxiety disorders, version 2 being more specific for detection of depression.Conclusion The WHO-5 showed a good internal and external validity. The second version is a stronger scale and was more specific for the detection of depression. The WHO-5 is an useful instrument for identifying elderly subjects with depression.

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Correspondence to Reinhard Heun.

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When meeting Per Bech, one has to admire his great enthusiasm for clinical and epidemiological research aimed at helping people.

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Heun, R., Bonsignore, M., Barkow, K. et al. Validity of the five-item WHO Well-Being Index (WHO-5) in an elderly population. Eur Arch Psychiatry Clin Nuerosci 251 (Suppl 2), 27–31 (2001). https://doi.org/10.1007/BF03035123

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