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Validity of the Brazilian version of the Geriatric Depression Scale (GDS) among primary care patients

Published online by Cambridge University Press:  03 November 2009

Milena Sampaio Castelo
Affiliation:
University of Fortaleza, Division of Mental Health, Fortaleza, CE, Brazil
João M. Coelho-Filho
Affiliation:
Faculty of Medicine, Federal University of Ceará, Division of Geriatric Medicine, Department of Clinical Medicine, Fortaleza, CE, Brazil
André F. Carvalho
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Clinical Medicine, Fortaleza, CE, Brazil
José W. O. Lima
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Community Health, Fortaleza, CE, Brazil
Jamile C. S. Noleto
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Clinical Medicine, Fortaleza, CE, Brazil
Kérsia G. Ribeiro
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Clinical Medicine, Fortaleza, CE, Brazil
José I. Siqueira-Neto*
Affiliation:
Faculty of Medicine, Federal University of Ceará, Division of Cognitive Neurology, Fortaleza, CE, Brazil
*
Correspondence should be addressed to: José Ibiapina Siqueira Neto MD, PhD, Faculdade de Medicine, Universidade Federal do Ceará, Departamento de Medicina Clínica, Rua Prof. Costa Mendes, 1608, 4o andar, 60430-040, Fortaleza, CE, Brazil. Phone: +55-85-33668054; Fax: +55–85-33668052. Email: jibiapinaneto@yahoo.com.br.

Abstract

Background: The aim of the present study was to determine the validity of the Brazilian version of the Geriatric Depression Scale (GDS) with 30 (GDS-30), 15 (GDS-15), 10 (GDS-10), 4 (GDS-4) and 1 (GDS-1) items and to calculate the optimum cutoff points for identifying depression among elderly primary care subjects.

Methods: A cross-sectional study was carried out involving 220 elderly patients recruited from four primary care clinics in northeastern Brazil. The following measurements were obtained: sociodemographic variables, Katz scale of independence in activities of daily living, and the GDS with 30, 15, 10, 4 and 1 item(s). A psychiatrist blinded to the results of the GDS applied the mood module of the Structured Clinical Interview for the DSM-IV for the diagnosis of major depressive episodes as the “gold standard.”

Results: The use of the cut-off point of 10/11 for the GDS-30 produced sensitivity and specificity rates of 92.0% (95% CI: 70–98) and 79% (95% CI: 73–85), respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 49% and 98%, respectively. The optimum cut-off point for the GDS-15 was 4/5, at which sensitivity was 87% (95% CI: 71–95) and specificity was 82% (95% CI: 76–91), PPV was 51% and NPV was 97%. At the cut-off point of 3/4 the sensitivity, specificity, PPV and NPV for the GDS-10 were 76% (95% CI: 60–89), 81% (95% CI: 75–87), 46% (95% CI: 33–59%), and 94% (95% CI 89–97%), respectively. The optimum cut-off point for the GDS-4 was 0/1, at which sensitivity was 84% (95% CI: 68–93%); specificity was 75% (95% CI; 68–91%); PPV was 41% and NPV was 96%. For the GDS-1, sensitivity was 47%, specificity was 96%; PPV was 69% and NPV was 90%.

Conclusions: The GDS-30, GDS-15, GDS-10 and GDS-4 proved to be good screening instruments for depression in primary care clinics in Brazil, whereas the GDS-1 failed to perform adequately.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2009

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References

Alexopoulos, G. S. et al. (2002). Assessment of late life depression. Biological Psychiatry, 52, 164174.CrossRefGoogle ScholarPubMed
Almeida, O. P. and Almeida, S. A. (1999a). Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. International Journal of Geriatric Psychiatry, 14, 858865.3.0.CO;2-8>CrossRefGoogle Scholar
Almeida, O. P. and Almeida, S. A. (1999b). Reliability of the Brazilian version of the Geriatric Depression Scale (GDS) short form. Arquivos de Neuropsiquiatria, 57, 421426.CrossRefGoogle ScholarPubMed
Barry, K. L., Fleming, M. F., Manwell, L. B., Copeland, L. A. and Appel, S. (1998). Prevalence of and factors associated with current and lifetime depression in older adult primary care patients. Family Medicine, 30, 366371.Google ScholarPubMed
Chaaya, M. et al. (2008). Validation of the Arabic version of the short Geriatric Depression Scale (GDS-15). International Psychogeriatrics, 20, 571581.CrossRefGoogle ScholarPubMed
Clément, J. P., Nassif, R. F., Leger, J. M. and Marchan, F. (1997). Development and contribution to the validation of a brief French version of the Yesavage Geriatric Depression Scale. Encephale, 23, 9199.Google Scholar
D'Ath, P., Katona, P., Mullan, E., Evans, S. and Katona, C. (1994). Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15-item Geriatric Depression Scale (GDS 15) and the development of short versions. Family Practice, 11, 260266.CrossRefGoogle Scholar
Evans, S. and Katona, C. (1993). Epidemiology of depressive symptoms in elderly primary care attenders. Dementia, 4, 327333.Google ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. (1995). Structured clinical interview for the DSM-IV axis I disorders (SCID I/P, version 2.0). New York, NY: Biometric Research Department, New York State: Psychiatric Institute.Google Scholar
Flahault, A., Cadilhac, M. and Thomas, G. (2005). Sample size calculation should be performed for design accuracy in diagnostic test studies. Journal of Clinical Epidemiology, 58, 859862.CrossRefGoogle ScholarPubMed
Gottfries, G. G., Noltorp, S. and Norgaard, N. (1997). Experience with a Swedish version of the Geriatric Depression Scale in primary care centres. International Journal of Geriatric Psychiatry, 12, 10291034.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
Harman, J. S., Crystal, S., Walkup, J. and Olfson, M. (2003). Trends in elderly patients’ office visits for the treatment of depression according to physician specialty: 1985–1999. Journal of Behavioral Health Services and Research, 30, 332341.CrossRefGoogle ScholarPubMed
Hoyl, M. T. et al. (1999). Development and testing of a five-item version of the Geriatric Depression Scale. Journal of the American Geriatrics Society, 47, 873878.CrossRefGoogle ScholarPubMed
Licht-Strunk, E. et al. (2005). Prevalence of depression in older patients consulting their general practitioner in The Netherlands. International Journal of Geriatric Psychiatry, 20, 10131019.CrossRefGoogle ScholarPubMed
Lino, V. T., Pereira, S. R., Camacho, L. A., Ribeiro Filho, S. T. and Buksman, S. (2008). Cross-cultural adaptation of the Independence in Activities of Daily Living Index (Katz Index). Cadernos de Saude Publica, 24, 103112.CrossRefGoogle ScholarPubMed
Montorio, I. and Izal, M. (1996). The Geriatric Depression Scale: a review of its development and utility. International Psychogeriatrics, 8, 103112.CrossRefGoogle Scholar
Paradela, E. M., Lourenco, R. A. and Veras, R. P. (2005). Validation of geriatric depression scale in a general outpatient clinic. Revista de Saude Publica, 39, 918923.CrossRefGoogle Scholar
Rinaldi, P. et al. (2003). Validation of the five-item geriatric depression scale in elderly subjects in three different settings. Journal of the American Geriatrics Society, 51, 694698.CrossRefGoogle ScholarPubMed
Scogin, F. and Shah, A. (2006). Screening older adults for depression in primary care settings. Health Psychology, 25, 675677.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric depression scale: recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165172.Google Scholar
Simon, G. E., Goldberg, D., Tiemens, B. G. and Ustun, T. B. (1999). Outcomes of recognized and unrecognized depression in an international primary care study. General Hospital Psychiatry, 21, 97105.CrossRefGoogle Scholar
van Marwijk, H. W., Wallace, P., de Bock, G. H., Hermans, J., Kaptein, A. A. and Mulder, J. D. (1995). Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. British Journal of General Practice, 45, 195199.Google ScholarPubMed
Wancata, J., Alexandrowicz, R., Marquart, B., Weiss, M. and Friedrich, F. (2006). The criterion validity of the Geriatric Depression Scale: a systematic review. Acta Psychiatrica Scandinavica, 114, 398410.CrossRefGoogle ScholarPubMed
Yesavage, J. A. et al. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatry Research, 17, 3749.CrossRefGoogle Scholar