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Diagnostic Performance of the Geriatric Depression Scale and the Beck Depression Inventory with Nursing Home Residents

Published online by Cambridge University Press:  29 November 2010

Réjeanne Laprise
Affiliation:
Laval University
Jean Vézina
Affiliation:
Laval University

Abstract

This study compared the diagnostic performance of the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) in correctly identifying depressed and nondepressed older people who are nursing home residents without cognitive disorders. At the usual cut-off scores of 10 and 11, sensitivity was 96.30 per cent for the BDI and 88.89 per cent for the GDS, while their specificity rates were 46.15 and 56.41 per cent respectively. Using Receiver Operating Characteristics (ROC) curves, the results obtained using these scales were compared with the diagnosis of psychiatric disorder according to the DSM-III-R. Contrary to the hypothesis, no difference was found between the area under the ROC for the BDI (Az = .87; SD = .04) and for the GDS (Az = .85; SD = .05). The exclusion of the somatic items, or the somatic factor, did not change the diagnostic performance of the BDI. Indices of temporal stability, concurrent validity and agreement with clinical diagnoses also confirmed the reliability and validity of these two scales for older people living in nursing homes.

Résumé

Cette étude avait comme objectif de comparer les performances diagnostiques de l'Inventaire de Dépression de Beck (IDB) et de l'Échelle de Dépression Gériatrique (EDG) à correctement identifier des adultes âgés déprimés et des adultes âgés non déprimés exempts de troubles cognitifs importants et vivant en centres d'accueil. Aux seuils-critères usuels de 10 et de 11, la sensibilité du IDB était de 96,30 pour cent et celle du EDG de 88,89 pour cent alors que la spécificité se situait à 46,15 et 56,41 pour cent respectivement. Les courbes caractéristiques du receveur (ROC) ont permis de confronter les résultats obtenus à ces échelles avec le diagnostic des psychiatres selon les critères du DSM-III-R. Contrairement à ce qui avait été prévu, aucune différence n'a été retrouvée entre la surface sous la courbe du IDB (Az = 0,87; é.t. = .04) et celle du EDG (Az = 0,85; é.t. = .05). Ce résultat indique l'équivalence des performances diagnostiques de ces deux échelles. L'exclusion des énoncés somatiques ou du facteur somatique n'a pas amélioré significativement la performance diagnostique du IDB. Des indices de stabilité temporelle, de validité concomitante et de concordance avec le diagnostic ont aussi confirmé la fidélité et la validité de ces deux échelles auprès de résidants cognitivement intacts vivant en centres d'accueil.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1998

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References

Akiskal, H.S. (1989). The classification of mental disorders. In Kaplan, H.L. & Sadock, B.J. (Eds.). Comprehensive textbook of psychiatry: Vol. 1 (5th ed.) (pp. 583598). Baltimore: Williams & Wilkins.Google Scholar
American Psychiatric Association (APA). (1987). Diagnostic and statistical manual of mental disorders-revised (3rd ed.). Washington, DC: Author.Google Scholar
Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New York, NY: Guilford Press.Google Scholar
Beck, A.T., & Steer, R.A. (1987). BDI- Beck Depression Inventory Manual. San Antonio: The Psychological Corporation.Google Scholar
Bourque, P., Blanchard, L., Saulnier, J., & Vézina, J. (1992). L'impact des symptômes somatiques dans l'évaluation de la dépression chez une population gériatrique. Revue Canadienne des Sciences du Comportement, 24, 118128.CrossRefGoogle Scholar
Bourque, P., Blanchard, L., & Vézina, J. (1990). Étude psychométrique de l'échelle de dépression gériatrique. Canadian Journal on Aging, 9, 348355.CrossRefGoogle Scholar
Brink, T.L., Yesavage, J.A., Owen, L., Heersema, P.H., Adey, M., & Rose, T.L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 3743.CrossRefGoogle Scholar
Folstein, M.F., Folstein, S., & McHugh, P.R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Forbes, W.F., Jackson, J.A., & Kraus, A.S. (1987). Institutionalization of the elderly in Canada. Toronto: Butterworths.Google Scholar
Gerety, M.B., Williams, J.W., Mulrow, C.D., Cornell, J.E., Kadri, A.A., Rosenberg, J., Chiodo, L.K., & Long, M. (1994). Performance of case-finding tools for depression in the nursing home: Influence of clinical and functional characteristics and selection of optimal threshold scores. Journal of the American Geriatrics Society, 42, 11031109.CrossRefGoogle ScholarPubMed
Hanley, J.A., & McNeil, B.J. (1982). The meaning and use of the area under a Receiver Operating Characteristic (Roc) Curve. Radiology, 143, 1936.CrossRefGoogle Scholar
Hsiao, J.K., Bartko, J.J., & Potter, W.Z. (1989). Diagnosing diagnoses. Receiver Operating Characteristics methods and psychiatry. Archives of General Psychiatry, 46, 664667.CrossRefGoogle ScholarPubMed
Hyer, L., & Blount, J. (1984). Concurrent and discriminant validities of Geriatric Depression Scale with older psychiatric inpatients. Psychological Reports, 54, 611616.CrossRefGoogle ScholarPubMed
Kafonek, S., Ettinger, W.H., Roca, R., Kittner, S., Taylor, N, & German, P.S. (1989). Instruments for screening for depression and dementia in a long-term care facility. Journal of the American Geriatrics Society, 37, 2934.CrossRefGoogle ScholarPubMed
Kendall, P.C., Hollon, S.D., Beck, A.T., Hammen, C.L., & Ingram, R.C. (1987). Issues and recommendations regarding the use of the Beck Depression Inventory. Cognitive Therapy and Research, 11, 289299.CrossRefGoogle Scholar
Kiernan, B.V., Wilson, D., Suter, N., Nagui, A., Moltzen, J.J., & Silver, G. (1986). Comparison of the Geriatric Depression Scale and Beck Depression Inventory. Clinical Gerontologist, 6, 5456.Google Scholar
Kivelä, S.L., Lehtomäki, E., & Kivekäs, J. (1986). Prevalence of depressive symptoms and depression in elderly Finnish home nursing patients and home help clients. International Journal of Social Psychiatry, 32, 313.CrossRefGoogle ScholarPubMed
McGivney, S.A., Mulvihill, M., & Taylor, B. (1994). Validating the Geriatric Depression Scale in the nursing home. Journal of the American Geriatrics Society, 42, 490492.CrossRefGoogle ScholarPubMed
Metz, C. (1978). Basic principles of Roc analysis. Seminars in Nuclear Medicine, 8, 283–209.CrossRefGoogle ScholarPubMed
Metz, C. (1986). Roc methodology in radiologie imaging. Investigate Radiology, 21, 720733.CrossRefGoogle Scholar
Metz, C. (1991). Clabroc. Department of Radiology: The University of Chicago.Google Scholar
National Institute of Health. (1992). Diagnosis and treatment of depression in late life. Journal of American Medical Association, 268, 10181024.CrossRefGoogle Scholar
Norris, J.T., Gallagher, D., Wilson, A., & Winograd, C.H. (1987). Assessment of depression validity of two screening measures. Journal of the American Geriatrics Society, 35, 989995.CrossRefGoogle ScholarPubMed
Olin, J.T., Schneider, L.S., Eaton, E.M., Zemansky, M.F., & Pollock, V.E. (1992). The Geriatric Depression Scale and the Beck Depression Inventory as screening instruments in an older adult outpatient population. Psychological Assessment, 4, 190192.CrossRefGoogle Scholar
Parmelee, P.A., Katz, I.R., & Lawton, M.P. (1989). Psychometric properties of the Geriatric Depression Scale among the hebergementalized aged. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1, 331338.CrossRefGoogle Scholar
Parmelee, P.A., Katz, I.R., & Lawton, M.P. (1992). Incidence of depression in long-term care settings. Journal of Gerontology: Medical Sciences, 47, M189–M196.CrossRefGoogle ScholarPubMed
Rapp, S.T., Parisi, S., Walsh, D.A., & Wallace, C.E. (1988). Detecting depression in elderly medical inpatients. Journal of Consulting and Clinical Psychology, 56, 509513.CrossRefGoogle ScholarPubMed
Snowdon, J., & Donnelly, N. (1986). A study of depression in nursing homes. Journal of Psychiatric Research, 20, 327333.CrossRefGoogle ScholarPubMed
Somoza, E., Steer, H.A., Beck, A.T., & Clark, D.A., (1994). Differentiating major depression and panic disorders by self-report and clinical rating scales: Roc analysis and information theory. Behaviour Research and Therapy, 32, 771782.CrossRefGoogle ScholarPubMed
Spitzer, R.L., Williams, J.B.W., Gibbon, M., & First, M.B. (1990). User's guide for the structured clinical interview for DSM-III-R, SCID. Washington, DC: American Psychiatric Press Inc.Google Scholar
Stukenberg, K.W., Dura, J.R., & Kiecolt-Glaser, J.K. (1990). Depression screening validation in an elderly community-dwelling population. Psychological Assessment. A Journal of Consulting and Clinical Psychology, 2, 134138.Google Scholar
Thompson, L.W. (1996). Cognitive-behavioral therapy and treatment for late-life depression. Journal of Clinical Psychiatry, 57(Suppl 5), 2937.Google ScholarPubMed
Vézina, J., Landreville, P., Bourque, P., & Blanchard, L. (1991). Inventaire de dépression de Beck: Etude psychométrique auprès d'une population âgée francophone. Canadian Journal on Aging, 10(1), 2939.CrossRefGoogle Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., & Leirer, V.O. (1983). Development and validation of a geriatric depression scale: A preliminary report. Journal of Psychiatrie Research, 17, 3749.CrossRefGoogle Scholar