Psychiatric morbidity among residents in a home for the elderly in spain: Prevalence of disorder and validity of screening

Abstract

AbstractAll residents in a home for elderly válidos (able) in Spain were interviewed and 101 completed the study. Non‐medical interviewers adminstered the GHQ‐28 items and either Zung's Self‐Rating Depression Scale (SDS) (N=69) or the Geriatric Depression Rating Scale (GDS) (N=31). The residents were also examined blind by psychiatrists standardized in the use of the Clinical Interview Scale (CIS), who also administered the ‘Mini‐Examen Cognoscitivo’, the Spanish version of the Mini‐Mental State Examination (MMSE), and diagnosed the identified ‘cases’ according to ICD‐9 criteria. Twenty‐one residents (20.8%) were considered to be ‘cases’ on the basis of the CIS; 14 (13.9%) were diagnosed as depressed and only four (4%) were diagnosed as being demented, although the mean age of the sample was 81.9 years (SD=5.6). Most ‘cases’; were of mild intensity and the differences with ‘non‐cases’; seemed quantitative rather than qualitative. The GHQ‐28 correctly identified 81.5% of ‘cases’; with a cutting score of 5/6 (sensitivity 70%, specificity 84.4%) and 77.4% of ‘cases’; with a cutting score of 4/5 (sensitivity 85%, specificity 75.3%), suggesting a discriminative power almost as good as in adult individuals. In the pilot study, the GDS performed better than the SDS as a screening instrument. The addition of the ‘Mini‐Examen’ would have improved the sensitivity of both the GHQ‐28 items and the SDS.