Screening for depression: Clinical validation of geriatricians? diagnosis, The Brief Assessment Schedule Depression Cards and the 5-item version of the Symptom Check List among non-demented geriatric inpatients

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In this study, two screening instruments for depression and geriatricians' diagnosis were compared against the Geriatric Mental State Schedule (GMS), a standardized semi-structured psychiatric interview. The Brief Assessment Schedule Depression Cards (BASDEC) achieved 91% sensitivity and 85% specificity using a cutoff score of 7. Its receiver operating characteristics (ROC) had an area under the curve (AUC) of 0.88, with 95% confidence intervals of 0.78 and 0.98. The 5-item version of the Symptom Check List (SCL-5) achieved 77% sensitivity and 74% specificity using a cutoff score of 10. Its AUC was 0.77, with 95% confidence intervals of 0.63 and 0.90. The p-value of the statistical difference between the two AUCs was 0.0554. The geriatricians' diagnosis had a kappa agreement coefficient of 0.39, sensitivity of 55% and specificity of 96%. They missed 45% of depressed patients. Routine screening with BASDEC would considerably improve the detection of depression. Even among those patients who did not appear depressed to the geriatricians, BASDEC would detect one case in every 10 patients.