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The geriatric depression scale in palliative care

Published online by Cambridge University Press:  28 July 2008

Gregory B. Crawford*
Affiliation:
Lyell McEwin Health Service, Elizabeth Vale, Australia Discipline of Medicine, University of Adelaide, Adelaide, Australia
Julie A. Robinson
Affiliation:
School of Psychology, Flinders University, Adelaide, Australia
*
Address correspondence and reprint requests to: G.B. Crawford, 89 Strangways Terrace, North Adelaide, 5006South Australia. E-mail: [email protected]

Abstract

Objective:

This research examined the psychometric properties of previously published short forms of the Geriatric Depression Scale (GDS) in patients receiving palliative care. It also uses the full form of the GDS to examine the prevalence of nonsomatic symptoms of depression in palliative patients.

Method:

Participants were 84 patients with advanced cancer attending palliative care outpatient clinics. Scores for short forms of the GDS were derived from administering the original 30-item scale. Patients also completed the single item numerical analogue scale for depression from the Edmonton Symptom Assessment System and parallel numerical analogue scales for will-to-live and hope. A subset of the sample completed the measures twice. Short forms were judged on the extent to which they captured information gained from the full scale and their internal consistency, test–retest reliability, convergent and concurrent validity, and their distribution of scores.

Results:

Overall, five short forms showed good psychometric properties at both visits. Two of these forms were very brief. Some nonsomatic symptoms assessed on the full GDS were reported with high frequency. However, few individuals reported a large number of symptoms. At both visits, patients identified as likely to have severe depression gave different responses from other patients on most items on the GDS-30.

Significance of results:

Several short forms of the GDS may be appropriate for use in palliative care. Patients identified as likely to have severe depression showed many of the same symptoms that characterise depression in other geriatric populations.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

Akamatsu, K., Saito, A., Wada, T., et al. (2005). Analysis of comprehensive geriatric assessment of elderly residents in a social welfare home for the aged compared with those in a residential care home in an urban area in Japan. Geriatrics and Gerontology International, 5, 5358.CrossRefGoogle Scholar
Akechi, T., Okamura, T., Sugawara, Y., et al. (2004). Suicidality in terminally ill Japanese patients with cancer. Cancer, 100, 183191.CrossRefGoogle ScholarPubMed
Almeida, O.P. & Almeida, S.A. (1999). 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
Andersen, B.L., Farrar, W.B., Golden-Kreutz, D.M., et al. (2004). Psychological, behavioral, and immune changes after a psychological intervention: A clinical trial. Journal of Clinical Oncology, 22, 35703580.CrossRefGoogle ScholarPubMed
Andersen, B.L., Farrar, W.B., Golden-Kreutz, D., et al. (2007). Distress reduction from a psychological intervention contributes to improved health for cancer patients. Brain, Behavior, and Immunity, 21, 953961.CrossRefGoogle ScholarPubMed
Arthur, A., Jagger, C., Lindesay, J., et al. (1999). Using an annual over-75 health check to screen for depression: Validation of the short Geriatric Depression Scale (GDS15) within general practice. International Journal of Geriatric Psychiatry, 14, 431439.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Bach, M., Nikolaus, T., Oster, P., et al. (1996). Depression in the elderly: The Geriatric Depression Scale (German). Zeitschrift für Gerontologie und Geriatrie, 28, 4246.Google Scholar
Baker, F.M. & Espino, D.V. (1997). A Spanish version of the Geriatric Depression Scale in Mexican-American elders. International Journal of Geriatric Psychiatry, 12, 2125.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Balducci, L. (2003). New paradigms for treating elderly patients with cancer: The comprehensive geriatric assessment and guidelines for supportive care. The Journal of Supportive Oncology, 1, 3037.Google ScholarPubMed
Beck, A.T., Ward, C.H., Mendelson, M., et al. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 5363.CrossRefGoogle ScholarPubMed
Bruera, E., Kuehn, N., Miller, M.J., et al. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 69.CrossRefGoogle ScholarPubMed
Bruera, E., Miller, L., McCallion, J., et al. (1992). Cognitive failure in patients with terminal cancer: A prospective study. Journal of Pain and Symptom Management, 7, 192195.CrossRefGoogle ScholarPubMed
Cassileth, B., Lusk, E., Strouse, T., et al. (1985). A psychological analysis of cancer patients and their next-of-kin. Cancer, 55, 7276.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Chen, H., Cantor, A., Meyer, J., et al. (2003). Can older cancer patients tolerate chemotherapy? A prospective pilot study. Cancer, 97, 11071114.CrossRefGoogle ScholarPubMed
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1994). Prevalence of depression in the terminally ill: Effects of diagnostic criteria and symptom threshold judgments. American Journal of Psychiatry, 151, 537540.Google ScholarPubMed
Chochinov, H.M., Wilson, K.G., Enns, M., et al. (1997). “Are you depressed?” Screening for depression in the terminally ill. American Journal of Psychiatry, 154, 674676.Google ScholarPubMed
Christakis, N.A. (1994). Timing of referral of terminally ill patients to an outpatient hospice. Journal of General Internal Medicine, 9, 314320.CrossRefGoogle Scholar
Clement, J.P., Nassif, R.F., Leger, J.M., et al. (1997). Development and contribution to the validation of a short French version of the Geriatric Depression Scale (French). Encephale, 23, 9199.Google Scholar
Cox, J.L., Holden, J.M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Depression Scale. British Journal of Psychiatry, 150, 782786.CrossRefGoogle Scholar
Dall, J. & Hopkins, A. (1992). Standardised assessment scale for elderly people. London: The Royal College of Physicians of London and the British Geriatrics Society.Google Scholar
D'Ath, P., Katona, P., Mullan, E., et al. (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 ScholarPubMed
Deschler, B., de Witte, T., Mertelsmann, R., et al. (2006). Treatment decision-making for older patients with high-risk myelodysplastic syndrome or acute myeloid leukemia: Problems and aproaches. Haematologica, 91, 15131522.Google ScholarPubMed
DiMatteo, M., Lepper, H., & Croghan, T. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 21012107.CrossRefGoogle ScholarPubMed
Duffy, S.A., Terrell, J.E., Valenstein, M., et al. (2002). Effect of smoking, alcohol, and depression on the quality of life of head and neck cancer patients. General Hospital Psychiatry, 24, 140147.CrossRefGoogle ScholarPubMed
Durkin, I., Kearney, M., & O'Siorain, L. (2003). Psychiatric disorder in a palliative care unit. Palliative Medicine, 17, 212218.CrossRefGoogle Scholar
Endicott, J. (1984). Measurement of depression in patients with cancer. Cancer, 53, 22432249.CrossRefGoogle ScholarPubMed
Extermann, M. (2003). Studies of comprehensive geriatric assessment in patients with cancer. Cancer Control, 10, 463468.CrossRefGoogle ScholarPubMed
Faller, H. & Bulzebruck, H. (2002). Coping and survival in lung cancer: A 10-year follow-up. American Journal of Psychiatry, 159, 21052107.CrossRefGoogle Scholar
Galaria, I.I., Casten, R.J., & Rovner, B.W. (2000). Development of a shorter version of the Geriatric Depression Scale for visually impaired older patients. International Psychogeriatrics, 12, 435443.CrossRefGoogle ScholarPubMed
Greenberg, L., Lantz, M.S., Likourezos, A., et al. (2004). Screening for depression in nursing home palliative care patients. Journal of Geriatric Psychiatry and Neurology, 17, 212218.CrossRefGoogle ScholarPubMed
Heisel, M.J., Flett, G.L., Duberstein, P.R., et al. (2005). Does the Geriatric Depression Scale (GDS) distinguish between older adults with high versus low levels of suicidal ideation? American Journal of Geriatric Psychiatry, 13, 876883.CrossRefGoogle ScholarPubMed
Hinton, J. (1994). Which patients with terminal cancer are admitted from home care? Palliative Medicine, 8, 197210.CrossRefGoogle ScholarPubMed
Hotopf, M., Chidgey, J., Addington-Hall, J., et al. (2002). Depression in advanced disease: A systematic review Part 1. Prevalence and case finding. Palliative Medicine, 16, 8197.Google ScholarPubMed
Hoyl, M.T., Alessi, C.A., Harker, J.O., 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
Jerant, A.F., Azari, R.S., Nesbitt, T.S., et al. (2004). The TLC model of palliative care in the elderly: Preliminary application in the assisted living setting. (Timely and team oriented, longitudinal, and collaborative and comprehensive). Annals of Family Medicine, 2, 5460.CrossRefGoogle Scholar
Kamboj, S.K., Tookman, A., Jones, L., et al. (2005). The effects of immediate-release morphine on cognitive functioning in patients receiving chronic opioid therapy in palliative care. Pain, 117, 388395.CrossRefGoogle ScholarPubMed
Kelly, B., Burnett, K., Pelusi, D., et al. (2003). Factors associated with the wish to hasten death: A study of patients with terminal illness. Psychological Medicine, 33, 7581.CrossRefGoogle Scholar
Kramer, J.A. (1999). Use of the Hospital Anxiety and Depression Scale (HADS) in the assessment of depression in patients with inoperable lung cancer. Palliative Medicine, 13, 353354.CrossRefGoogle ScholarPubMed
Le Fevre, P., Devereux, J., Smith, S., et al. (1999). Screening for psychiatric illness in the palliative care inpatient setting: A comparison between the Hospital Anxiety and Depression Scale and the General Health Questionnaire-12. Palliative Medicine, 13, 399407.CrossRefGoogle ScholarPubMed
Lin, E.H.B., Katon, W., Von Korff, M., et al. (2003). Effect of improving depression care on pain and functional outcomes among older adults with arthritis: A randomized controlled trial. JAMA, 290, 24282434.CrossRefGoogle ScholarPubMed
Liu, C.Y., Lu, C.H., Yu, S., et al. (1998). Correlations between scores on Chinese versions of long and short forms of the Geriatric Depression Scale among elderly Chinese. Psychological Reports, 82, 211214.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M., Dennis, M., & Taylor, F. (2004). A prospective study to compare three depression screening tools in patients who are terminally ill. General Hospital Psychiatry, 26, 384389.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M., Friedman, T., & Rudd, N. (2000). Criterion validation of the Edinburgh Postnatal Depression Scale as a screening tool for depression in patients with advanced metastatic cancer. Journal of Pain and Symptom Management, 20, 259265.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M., Friedman, T., & Rudd, N. (2001). An analysis of the validity of the Hospital Anxiety and Depression Scale as a screening tool in patients with advanced metastatic cancer. Journal of Pain and Symptom Management, 22, 990996.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M. & Payne, S. (2003). A qualitative study of clinical nurse specialists’ views on depression in palliative care patients. Palliative Medicine, 17, 334338.CrossRefGoogle ScholarPubMed
Lloyd-Williams, M. & Riddleston, H. (2002). The stability of depression scores in patients who are receiving palliative care. Journal of Pain and Symptom Management, 24, 593597.CrossRefGoogle ScholarPubMed
Lynch, M.E. (1995). The assessment and prevalence of affective disorders in advanced cancer. Journal of Palliative Care, 11, 1018.CrossRefGoogle ScholarPubMed
Lyness, J.M., Noel, T.K., Cox, C., et al. (1997). Screening for depression in elderly primary care patients: A comparison of the centre for epidemiologic studies-depression scale and the Geriatric Depression Scale. Archives of Internal Medicine, 157, 449454.CrossRefGoogle ScholarPubMed
Maher, E.J., Mackenzie, C., Young, T., et al. (1996). The use of the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-C30 questionnaires to screen for treatable unmet needs in patients attending routinely for radiotherapy. Cancer Treatment Reviews, 22(Suppl. A), 123129.CrossRefGoogle ScholarPubMed
Mann, E., Koller, M., Mann, C., van der Cammen, T. & Steurer, J. (2004). Comprehensive geriatric assessment (CGA) in general practice: Results from a pilot study in Voralberg, Austria. BioMed Central Geriatrics, 4.Google Scholar
Massie, M.J. & Holland, J.C. (1990). Depression and the cancer patient. Journal of Clinical Psychiatry, 51(7 Suppl), 1217.Google ScholarPubMed
Meyer, H.A.M., Sinnot, C., & Seed, P.T. (2003a). Depressive symptoms in advanced cancer. Part 1. Assessing depression: The Mood Evaluation Questionnaire. Palliative Medicine, 17, 596603.CrossRefGoogle ScholarPubMed
Meyer, H.A.M., Sinnot, C., & Seed, P.T. (2003b). Depressive symptoms in advanced cancer. Part 2. Depression over time; the role of the palliative care professional. Palliative Medicine, 17, 604607.CrossRefGoogle ScholarPubMed
Molloy, D.W., Standish, T.I., Dubois, S., et al. (2006). A short screen for depression: The AB Clinician Depression Screen (ABCDS). International Psychogeriatrics, 18, 481492.CrossRefGoogle Scholar
Murtagh, F.E.M., Addington-Hall, J.M., & Higginson, I.J. (2007). The value of cognitive interviewing techniques in palliative care research. Palliative Medicine, 21, 8793.CrossRefGoogle ScholarPubMed
Olin, J.T., Schneider, L.S., Eaton, E.M., et al. (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
Osterweil, D. (2003). Comprehensive geriatric assessment: Lessons in progress. Israeli Medical Association Journal, 5, 371374.Google ScholarPubMed
Overcash, J.A., Beckstead, J., Extermann, M., et al. (2005). The abbreviated comprehensive geriatric assessment (CGA): A retrospective analysis. Critical Reviews in Oncology Haematology, 54, 129136.CrossRefGoogle ScholarPubMed
Passik, S.D., Kirsh, K.L., Theobald, D., et al. (2002). Use of a depression screening tool and a Fluoxetine-based algorithm to improve the recognition and treatment of depression in cancer patients: A demonstration project. Journal of Pain and Symptom Management, 24, 318327.CrossRefGoogle Scholar
Razavi, D., Delvaux, N., Farvacques, C., et al. (1990). Screening for adjustment disorders and major depressive disorders in cancer in-patients. British Journal of Psychiatry, 156, 7983.CrossRefGoogle ScholarPubMed
Repetto, L., Fratino, L., Audisio, R.A., et al. (2002). Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group Performance Status in elderly cancer patients: An Italian group for geriatric oncology study. Journal of Clinical Oncology, 20, 494502.CrossRefGoogle Scholar
Riccio, D., Solinas, A., Astara, G., et al. (2007). Comprehensive geriatric assessment in female elderly patients with Alzheimer's disease and other types of dementia. Archives of Gerontology and Geriatrics - Supplement, 1, 343353.CrossRefGoogle Scholar
Robinson, J.A. & Crawford, G.B. (2005). Identifying palliative care patients with symptoms of depression: An algorithm. Palliative Medicine, 19, 278287.CrossRefGoogle ScholarPubMed
Sela, R.A. (2007). Screening for depression in palliative cancer patients attending a pain and symptom control clinic. Palliative and Supportive Care, 5, 207217.CrossRefGoogle ScholarPubMed
Shah, A., Phongsathorn, V., Bielawska, C., et al. (1996). Screening for depression among geriatric inpatients with short verisons of the geriatric depression scale. International Journal of Geriatric Psychiatry, 11, 915918.3.0.CO;2-H>CrossRefGoogle Scholar
Sharp, L.K. & Lipsky, M.S. (2002). Screening for depression across the lifespan: A review of measures for use in primary care settings. (Problem-oriented diagnosis). American Family Physician, 66, 10011007.Google Scholar
Sheik, J. & Yesavage, J. (1986). Geriatric Depression Scale. Recent evidence and development of a shorter version. In Clinical Gerontology: A Guide to Assessment and Intervention, Brink, T. (ed.), pp. 165173. New York: Howarth Press.Google Scholar
Smith, E.M., Gomm, S.A., & Dickens, C.M. (2003). Assessing the independent contribution to quality of life from anxiety and depression in patients with advanced cancer. Palliative Medicine, 17, 509513.CrossRefGoogle ScholarPubMed
Spiegel, D. (1996). Cancer and depression. British Journal of Psychiatry, 168(Suppl. 30), 109116.CrossRefGoogle Scholar
Spitzer, R.L., Endicott, J., & Robins, E. (1978). Research Diagnostic Criteria. Rationale and reliability. Archives of General Psychiatry, 35, 773782.CrossRefGoogle ScholarPubMed
Sullivan, P.S. & Dworkin, M.S. (2003). Prevalence and correlates of fatigue among persons with HIV infection. Journal of Pain and Symptom Management, 25, 329333.CrossRefGoogle ScholarPubMed
Sutcliffe, C., Cordingley, L., Burns, A., et al. (2000). A new version of the Geriatric Depression Scale for nursing and residential home populations: The Geriatric Depression Scale (Residential) GDS-12R. International Psychogeriatrics, 12, 173181.CrossRefGoogle ScholarPubMed
Unutzer, J., Patrick, D.L., Simon, G., et al. (1997). Depressive symptoms and the cost of health services in HMO patients aged 65 years and older: A 4-year prospective study. JAMA, 227, 16181623.CrossRefGoogle Scholar
Urch, C.E., Chamberlain, J., & Field, G. (1998). The drawbacks of the Hospital Anxiety and Depression Scale in the assessment of depression in hospice inpatients. Palliative Medicine, 12, 395396.CrossRefGoogle ScholarPubMed
van Marwijk, H.W.J., Arnold, I., Bonnema, J., et al. (1993). Self-reporting depression scales for elderly patients in primary care: A preliminary study. Family Practice, 10, 6365.CrossRefGoogle Scholar
van Marwijk, H.W.J., Wallace, P., De Bock, G.H., et al. (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
Wada, T., Wada, C., Ishine, M., et al. (2005). Comprehensive geriatric assessment for community-dwelling elderly in Asia compared with those in Japan: V. West Java in Indonesia. Geriatrics and Gerontology International, 5, 168175.CrossRefGoogle Scholar
Weeks, S.K., McGann, P.E., Michaels, T.K., et al. (2003). Comparing various short-form Geriatric Depression Scales leads to the GDS-5/15. Journal of Nursing Scholarship. Second Quarter, 133137.CrossRefGoogle Scholar
Wieland, D. & Hirth, V. (2003). Comprehensive geriatric assessment. Cancer Control, 10, 454462.CrossRefGoogle ScholarPubMed
Yesavage, J.A., Brink, T.L., Rose, T.L., et al. (1982–1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 3749.CrossRefGoogle Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.CrossRefGoogle ScholarPubMed