Psychiatr Prax 2011; 38(6): 280-286
DOI: 10.1055/s-0030-1266105
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Validität der Geriatrischen Depressionsskala bei Altenheimbewohnern: Vergleich von GDS-15, GDS-8 und GDS-4

Validity of the Geriatric Depression Scale in Nursing Home Residents: Comparison of GDS-15, GDS-8, and GDS-4Antje-Kathrin  Allgaier1 , Dietmar  Kramer2 , Roland  Mergl2 , Sabina  Fejtkova2 , Ulrich  Hegerl2
  • 1Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie der Universität München
  • 2Klinik und Poliklinik für Psychiatrie der Universität Leipzig
Further Information

Publication History

Publication Date:
19 May 2011 (online)

Zusammenfassung

Anliegen Untersuchung der Validität der Geriatrischen Depressionsskala in der 15-Item-Version (GDS-15) sowie der Kurzformen GDS-8 und GDS-4 an einer Stichprobe von 92 Altenheimbewohnern. Methode Ermittlung der Validitätskennwerte bezüglich majorer und minorer Depressionen nach den Kriterien des Strukturierten Klinischen Interviews für DSM-IV (SKID) als Goldstandard. Ergebnisse Die diagnostische Güte der GDS-15 war höher für majore Depressionen als für minore Depressionen (area under the ROC curve: 89,7 vs. 73,4 %). Die GDS-8 erreichte vergleichbare Werte, die GDS-4 nicht. Schlussfolgerungen Die GDS-8 ist aufgrund ihrer Kürze der GDS-15 vorzuziehen. Die GDS-4 kann nicht empfohlen werden.

Abstract

Objective To assess and compare the validity of the German 15-item version and shortened versions of the Geriatric Depression Scale (GDS) for early detection of depression in nursing home residents with mild to moderate cognitive impairment (MMSE ≥ 15). Methods Data from 92 patients were analysed. The Structural Clinical Interview for DSM-IV (SCID) was used as the gold standard. The diagnoses covered in this assessment were current major depression (MD) and minor depression (MinD). The performance of the GDS scales was evaluated using receiver operating characteristics (ROC). Main outcome measures were AUC (area under curve) values, as well as sensitivity and specificity. Results Overall diagnostic validity of the GDS-15 was better for MD than for MinD (AUC: 89.7 % and 73.4 %, respectively). In assessing MD, AUC values as well as sensitivity and specificity were comparable for the GDS-15 and the GDS-8. A cut-off point ≥ 5 on the GDS-8 gave optimum performance (sensitivity: 76.9 %, specificity: 88.6 %). For the best cut-off point ≥ 2, the corresponding values of the GDS-4 were 53.8 % and 92.4 %. Conclusions The GDS-8 appears to be a less time-consuming alternative for the nursing home setting. However, the GDS-4 is not suitable for this population.

Literatur

  • 1 Copeland J R, Beekman A T, Braam A W et al. Depression among older people in Europe: the EURODEP studies.  World Psychiatry. 2004;  3 45-49
  • 2 Luppa M, Sikorski C, Luck T et al. Age- and gender-specific prevalence of depression in latest-life – Systematic review and meta-analysis.  J Affect Disord. 2010;  doi: DOI: 0.1016/j.jad.2010.11.033
  • 3 Riedel-Heller S G, Luppa M, König H H. Institutionalisierung psychisch kranker alter Menschen.  Psychiat Prax. 2010;  37 53-55
  • 4 Jongenelis K, Pot A M, Eisses A M et al. Depression among older nursing home patients. A review.  Tijdschr Gerontol Geriatr. 2003;  34 52-59
  • 5 Seitz D, Purandare N, Conn D. Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review.  Int Psychogeriatr. 2010;  22 1025-1039
  • 6 Thakur M, Blazer D G. Depression in long-term care.  J Am Med Dir Assoc. 2008;  9 82-87
  • 7 Kramer D, Allgaier A K, Fejtkova S et al. Depression in nursing homes: prevalence, recognition, and treatment.  Int J Psychiatry Med. 2009;  39 345-358
  • 8 Barca M L, Engedal K, Laks J et al. A 12 months follow-up study of depression among nursing-home patients in Norway.  J Affect Disord. 2010;  120 141-148
  • 9 Kane K D, Yochim B P, Lichtenberg P A. Depressive symptoms and cognitive impairment predict all-cause mortality in long-term care residents.  Psychol Aging. 2010;  25 446-452
  • 10 Eikelmann B. Psyche trifft Körper – der komorbide Patient als echte Herausforderung der Interdisziplinarität.  Psychiat Prax. 2010;  37 265-267
  • 11 Yesavage J A, Brink T L, Rose T L et al. Development and validation of a geriatric depression screening scale: a preliminary report.  J Psychiatr Res. 1982;  17 37-49
  • 12 Sheikh J I, Yesavage J A. Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version.  Clin Gerontol. 1986;  5 165-173
  • 13 Mitchell A J, Bird V, Rizzo M et al. Diagnostic validity and added value of the Geriatric Depression Scale for depression in primary care: a meta-analysis of GDS30 and GDS15.  J Affect Dis. 2010;  125 10-17
  • 14 Wancata J, Alexandrowicz R, Marquart B et al. The criterion validity of the Geriatric Depression Scale: a systematic review.  Acta Psychiatr Scand. 2006;  114 398-410
  • 15 Mitchell A J, Bird V, Rizzo M et al. Which version of the geriatric depression scale is most useful in medical settings and nursing homes? Diagnostic validity meta-analysis.  Am J Geriatr Psychiatry. 2010;  18 1066-1077
  • 16 Marc L G, Raue P J, Bruce M L. Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population.  Am J Geriatr Psychiatry. 2008;  16 914-921
  • 17 Spitzer R I. User’s Guide for the Structured Clinical Interview for DSM-III-R: SCID.. Washington, DC: American Psychiatric Press; 1990
  • 18 Jongenelis K, Pot A M, Eisses A M et al. Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients.  Int J Geriatr Psychiatry. 2005;  20 1067-1074
  • 19 World Health Organization .Schedules for Clinical Assessment in Neuropsychiatry (SCAN),. Dutch edition: Giel R, Nienhuis FJ. 1999. SCAN 2.1: Vragenschema’s voor de klinische beoordeling in de neuropsychiatrie. Groningen: Swets & Zeitlinger; 1999
  • 20 Gauggel S, Birkner B. Validität und Reliabilität einer deutschen Version der Geriatrischen Depressionsskala (GDS).  Z Klin Psychol Psychother. 1999;  28 18-27
  • 21 D’Ath P, Katona P, Mullan E et al. Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions.  Fam Pract. 1994;  11 260-266
  • 22 Jongenelis K, Gerritsen D L, Pot A M et al. Construction and validation of a patient- and user-friendly nursing home version of the Geriatric Depression Scale.  Int J Geriatr Psychiatry. 2007;  22 837-842
  • 23 Rinaldi P, Mecocci P, Benedetti C et al. Validation of the five-item geriatric depression scale in elderly subjects in three different settings.  J Am Geriatr Soc. 2003;  51 694-698
  • 24 Shah A, Phongsathorn V, Bielawska C et al. Screening for depression among geriatric inpatients with short versions of the geriatric depression scale.  Int J Geriatr Psychiatry. 1996;  11 915-918
  • 25 Wittchen H U, Wunderlich U, Gruschwitz S et al. SKID-I Strukturiertes Klinisches Interview für DSM-IV. Achse I: Psychische Störungen, Interviewheft und Beurteilungsheft.. Göttingen: Hogrefe; 1997
  • 26 Folstein M F, Folstein S E, McHugh P R. „Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.  J Psychiatr Res. 1975;  12 189-198
  • 27 McGivney S A, Mulvihill M, Taylor B. Validating the GDS depression screen in the nursing home.  J Am Geriatr Soc. 1994;  42 490-492
  • 28 APA .Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).. 4th ed. Washington, DC: American Psychiatric Association; 1994
  • 29 WHO .Info Package: Mastering Depression in Primary Care, Version 2.2.. Frederiksborg: WHO Regional Office for Europe – Psychiatric Research Unit; 1998
  • 30 Sutcliffe C, Cordingley L, Burns A et al. A new version of the geriatric depression scale for nursing and residential home populations: the geriatric depression scale (residential) (GDS-12R).  Int Psychogeriatr. 2000;  12 173-181
  • 31 DeLong E R, DeLong D M, Clarke-Pearson D L. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.  Biometrics. 1988;  44 837-845
  • 32 Teresi J, Abrams R, Holmes D et al. Prevalence of depression and depression recognition in nursing homes.  Soc Psychiatry Psychiatr Epidemiol. 2001;  36 613-620
  • 33 Kafonek S, Ettinger W, Roca R et al. Instruments for screening for depression and dementia in a long-term care facility.  J Am Geriatr Soc. 1989;  37 29-34
  • 34 Schumacher J, Zedlick D, Frenzel G. Depressivität und kognitive Beeinträchtigungen bei Altenpflegeheim-Bewohnern.  Z Gerontol Geriatr. 1997;  30 46-53
  • 35 Defrancesco M, Marksteiner J, Deisenhammer E A et al. Zusammenhang zwischen Mild Cognitive Impairment (MCI) und Depression.  Neuropsychiatr. 2009;  23 144-150

Dr. rer. biol. hum. Antje-Kathrin Allgaier, Dipl.-Psych.

Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie der Universität München

Pettenkoferstraße 8a

80336 München

Email: Antje.Allgaier@med.uni-muenchen.de

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