Screening Tool For Depressive Symptoms Research Articles

Evaluating the Validity and Measurement Invariance of the Patient Health Questionnaire-9 Among Canadian Nurses.

Background and Purpose: The patient health questionnaire 9 item (PHQ-9) is a widely used self-reported measure for screening depressive symptoms. This study aims to examine measurement invariance and psychometric properties of the PHQ-9 for screening depressive symptoms in nurses across different nursing roles, gender, and workplace sector. Methods: The study is a secondary analysis of pre-COVID and COVID-19 survey data from 4,176 nurses and 3,238 nurses in British Columbia. Data from the PHQ-9 tested the assumption of unidimensionality, reliability, and presence of differential item functioning (DIF). Results: The PHQ-9 showed excellent internal consistency (r = .9) and a unidimensional factor structure. PHQ-9 items were free of DIF across nursing roles, gender, and workplace sector. Conclusions: This study supported the valid use of the PHQ-9 as a screening tool for depressive symptoms among nurses.

Dietary Fats and Depressive Symptoms in Italian Adults.

Depression represents one of the major causes of disability worldwide, with an important socioeconomic cost. Although many risk factors have been considered in its pathogenesis, nutrition seems to play a determinant role in its prevention. With regard to individual macronutrients, dietary fats and especially n-3 polyunsaturated fatty acids (n-3 PUFA) are the most studied. However, previous data about other dietary fatty acids, such as n-6 PUFA, are conflicting, and little is known about saturated fatty acids (SFA), especially when considering carbon chain length. Thus, we investigated whether single types and subtypes of dietary fats are related to depressive symptoms in Italian individuals living in the Mediterranean area. Dietary and socio-demographic data of 1572 individuals were analyzed. Food frequency questionnaires (FFQs) were used to determine the consumption of total dietary fat and each specific class of dietary fat, such as SFA, monounsaturated fatty acid (MUFA), and PUFA. The intake of fatty acids was also assessed according to the carbon-chain length of each single class. The Center for Epidemiologic Studies Depression Scale (CES-D) was used as a screening tool for depressive symptoms. After adjustment for potential confounding factors, a significant inverse association between low/moderate levels of PUFA intake and depressive symptoms (Q2 vs. Q1, odds ratio (OR) = 0.60, 95% CI: 0.44, 0.84) was found. On the other hand, moderate saturated fat consumption was associated with depressive symptoms (Q3 vs. Q1, OR = 1.44, 95% CI: 1.02, 2.04). However, when considering carbon chain length, individuals with a lower to moderate intake of short-chain saturated fatty acids (SCSFA) and medium-chain saturated fatty acids (MCSFA) were less likely to have depressive symptoms (Q3 vs. Q1, OR = 0.48, 95% CI: 0.31, 0.75), while moderate intake of arachidic acid (C20:0) was directly associated with depressive symptoms (Q3 vs. Q1, OR = 1.87, 95% CI: 1.26, 2.77). Among single MUFAs, higher myristoleic acid (C14:1) intake was directly associated with depressive symptoms (Q4 vs. Q1, OR = 1.71, 95% CI: 1.12, 2.61), while moderate intake of erucic acid (C22:1) was associated with lower odds of having depressive symptoms (Q3 vs. Q1, OR = 0.54, 95% CI: 0.33, 0.86). When considering individual PUFAs, individuals with moderate and higher intakes of arachidonic acid (C20:4) were less likely to have depressive symptoms (OR = 0.64, 95% CI: 0.45, 0.91; OR = 0.59, 95% CI: 0.38, 0.91, respectively). Similarly, higher eicosapentaenoic acid (C20:5) intake was inversely associated with depressive symptoms (Q4 vs. Q1, OR = 0.35, 95% CI: 0.12, 0.98), while a significant association for docosahexaenoic acid (C22:6) was retrieved only for low intakes (Q2 vs. Q1, OR = 0.33, 95% CI: 0.12, 0.88). Dietary fat intake may be associated with depressive symptoms, underlying the importance of distinguishing between different fat types. This study confirms the pivotal role of PUFAs and reopens the debate on the role of saturated fatty acids, suggesting plausible effects of moderate intakes of short-chain fatty acids.

Social and Behavioral Rhythms is Related to the Perception of Quality of Life in Old Adults

Introduction: The purpose is to verify in old adults if social and behavioral rhythms (SBRs) are correlated with a positive perception of the quality of life (QoL). Social and behavioral rhythms and related circadian biorhythms are known as central points in the pathophysiology of bipolar disorders. A secondary aim is to see if a similar relationship can be found in Major Depressive Disorder (MDD) in old adults. Sample: 141 people aged ≥65 years (58.9% Female). Methods: Each subject was evaluated using the Social and Behavioral Rhythms Scale (in which higher scores show more dysfunctional SRBs); SF-12 for QoL and a screening tool for depressive symptoms. They underwent a medical evaluation and blood level assays including cholesterol and triglycerides. The medical diagnoses including MDD were taken into account. Results: The Social and Behavioral Rhythms Scale score correlated inversely with SF-12 score (p<0.001) and positively with PHQ9 (p<0.0001). People with MDD had a higher score on social rhythms than controls without (p<0.01). The study highlighted, for the first time, that social and behavioral rhythms have a role in old adults living in the community. Conclusion: Further longitudinal studies with a sufficient number of individuals will be required to confirm these data and clarify causal links of the association.

The Patient Health Questionnaire (PHQ-9) as a tool to screen for depression in people with multiple sclerosis: a cross-sectional validation study

Background:Depression has a point prevalence of 25% and lifetime prevalence of 50% in people with multiple sclerosis (pwMS). Due to accessibility and brevity, the 9-item Patient Health Questionnaire (PHQ-9) may be a useful tool in clinical practice for screening and monitoring of depressive symptoms in people with MS (pwMS).Methods:The objective of this study was to evaluate the reliability, validity and acceptability of the PHQ-9 as a screening tool for depressive symptoms in pwMS. PwMS completed online questionnaires at 3 time-points over 4-weeks. The PHQ-9, Multiple Sclerosis Impact Scale (MSIS-29), Centre for Disease Control Health-Related Quality of Life Measure (CDC-HQOL-4) and clinical history.Results:103 participants completed the PHQ-9 at three time points, 43% were categorised as depressed on at least one response. The PHQ-9 exhibited high internal reliability (Cronbach’s α = 0.89), and test-re-test agreement (ICC 0.89, 95% CI 0.85–0.91). Convergent validity was indicated through positive correlation with the mental health items on the MSIS-29 (r = 0.46 and r = 0.50) and CDC-HQOL-4 (r = 0.79 and r = 0.73) at both assessment points. Positive correlations between the PHQ-9 and the MSIS-29 (r = 0.86 and r = 0.84) and CDC-HQOL-4 (r = 0.55 and r = 0.37) physical symptom sub-scores did not indicate divergent validity. 93% of ratings evaluated the PHQ-9 as “Very” or “Completely” acceptable.Conclusion:The PHQ-9 is a reliable and valid measure of depressive symptoms in people with MS. Given its accessibility, ease of administration, and acceptability, we recommend the PHQ-9 as a tool to screen for depressive symptoms in people with MS.

Confirmatory Factor Analysis of Center for Epidemiological Studies Depression 10-item Scale on Chinese International Students in Korea

Introduction: Depression has become increasingly prevalent in Chinese international students in South Korea. For this population, therefore, accurate assessment of mood disorders, particularly depression, is critically important. The 10-item Center for Epidemiological Studies Depression Scale (CES-D 10) is commonly used to measure depression in both clinical and non-clinical populations. Thus, this study examined the CES-D 10’s factor structure and psychometric properties in Chinese international students. Methods: Study participants were 250 Chinese international students aged 18–23, attending a four-year university in Korea; they completed the Chinese version of the CES-D 10. Based on relevant theories and empirical research, confirmatory factor analysis was employed to examine the adequacy of three competing models’ factor structure. Internal consistency reliability was assessed using Cronbach’s alpha, and test-retest reliability using the Pearson correlation coefficient. Results: Confirmatory factor analysis suggested that the two-factor model comprised of depressive affect/somatic retardation and positive affect had the best fit. The CES-D 10 showed satisfactory internal consistency and test-retest reliability in Chinese international students. Conclusion: The CES-D 10 demonstrated strong psychometric properties in this Chinese international student sample, and results suggest that the CES-D scale is a useful screening tool for depressive symptoms. Therefore, the CES-D 10 could be used as a depression screen for international students at the population level and in health clinics.

777 Use of the PHQ-2 as a Depression Screening Tool

Abstract Introduction In 2015, the Burn Quality Improvement Program (BQUIP) guidelines recommended systematic screening of Major Depressive Disorder at all verified burn centers. Our level one trauma center rolled out a program to screen all patients entering the burn service starting in June 2018. This project evaluates the program after the first year of implementation. Methods All patients over age 12 admitted to the burn service were screened by bedside nurses using the 2-item Patient Health Questionnaire (PHQ-2). Exclusion for screening included those who were intubated and sedated and/or not alert or oriented. A reminder for the PHQ-2 screener automatically popped up in the nursing task list in the electronic medical record until it was given or patient was coded as not appropriate for screening. Results A total of 509 patients were admitted to the Burn Service between June 2018 and May 2019. Of those, 40 were identified as not being appropriate for screening due to prolonged mental impairment (e.g. not able to regain consciousness), and 116 (24%) were not screened for unknown reasons. The remaining patients (n=353, 77%) were screened with the PHQ-2 and 94% of these patients were screened on the same day of admit. Of the patients screened, 28 (8%) scored above the clinical cut-off for probable depression (PHQ-2 ³ 3) and 265 (75.1%) did not endorse any symptoms on the PHQ-2 (PHQ-2 = 0). Of the 28 that screened positive on the PHQ-2, 16 (57.1%) received psychological services. Of those that did not receive psychology services, the majority were admitted for less than 3 days (n=10, 76.9%). Conclusions In the first year of the program the vast majority of eligible patients were able to be screened by nursing staff with a 2-item measure within one day of admit to the burn service. This success is likely due to the automation of the task in the electronic medical record, the ease of use of the PHQ-2 and the dedication of the nursing staff. The 8% rate of a positive screen is higher than the general population. Given that most patients were screened within 24 hours of admission, we are capturing depressive symptoms that predate the injury. We know that depression can impair burn recovery (e.g. affect participation in therapy, impede wound healing) and lead to poorer long term outcomes. Systematic screening of depressive symptoms upon admission will allow us to intervene earlier and potentially reduce barriers to optimal recovery. Despite high screening rates, about 40% of patients did not receive psychological intervention. We will be discussing utilization of resources for providing inpatient services to patients with a positive screen. Applicability of Research to Practice The PHQ-2 is an effective screening tool for depressive symptoms for patients on an inpatient burn unit. These findings are important for hospital systems looking to screen for and treat the mental health needs of burn patients. Depression screening will be required for BQUIP starting in 2020.

Depressive symptoms associated with physical health problems in midlife women: A longitudinal study

Background: It is unclear if the relationship between depression and physical health problems in women is related to age, reproductive stage, obesity or socio-demographic risk factors. MethodsLongitudinal data were obtained every 6 months for 36 months in 264 midlife African American, Caucasian and Latina women who began the study as healthy regularly menstruating 40 to 50-year-olds; 75 transitioned to peri- or post-menopause by 36 months. Scores of 16 or higher on the Center for Epidemiologic Studies-Depression (CES-D) scale were used to estimate depression risk. ResultsDepression risk was 28% at study initiation and 25% at 36 months. Significantly more women at risk for depression were unemployed, obese, or hypertensive. Women at risk were more likely to become peri- or post-menopausal during the study period. A higher percentage (38%) of overweight and obese women had CES-D scores ≥ 16 compared to normal weight women (23%; p < .001). Over half (58%) of the 73 women at higher depression risk at the initial visit reported a health problem or chronic illness at 36 months, compared to only 36% of the 191 women with CES-D scores <16 (p = .001). LimitationsThis was a secondary analysis of data from a relatively healthy sample of women in the decade before menopause. Chronic illness was self-reported and the CES-D is a screening tool for depressive symptoms rather than a clinical diagnostic tool. ConclusionsHealth care providers may be underestimating the impact of unemployment on depressive symptoms, obesity and chronic health problems in midlife women.

Association between severity of depressive symptoms and chronic knee pain in Korean adults aged over 50 years: a cross-sectional study using nationally representative data

ObjectivesTo identify the association between the presence and severity of depressive symptoms and those of chronic knee pain.DesignA retrospective cross-sectional study.ParticipantsWe used data from the sixth Korea National Health and...

The Psychometric Properties of the Outcome Rating Scale Used in Practice: A Narrative Review

ABSTRACTBackground: The Outcome Rating Scale (ORS) is a measure frequently utilized in clinical practice settings to monitor client therapeutic progress and assess therapeutic outcomes. The ORS was designed to be used in clinical practice; therefore, demonstration of adequate reliability and evidence of validity with clinical populations is ideal. To our knowledge, there have been no reviews evaluating the overall adequacy of the psychometric properties of the ORS specific to its use with clinical populations.Purpose: The aim of this study was to review all available articles presenting information about the psychometric properties of the ORS to examine its usefulness with clinical populations.Methods: We completed an electronic literature search of several online databases in order to identify relevant articles. We identified 24 articles that met our inclusion criteria and analyzed the reliability and validity evidence for the ORS with clinical populations.Results: Findings showed moderately high to high internal consistency for the ORS and support for the ORS as a screening measure and monitoring tool for subjective symptoms of psychological distress. However, there is insufficient evidence to support the use of the ORS as a diagnostic tool or for assessing behavioral changes or outcomes.Discussion: Clinicians should be aware of the concurrent validity results indicating that the ORS may be best thought of as closer to a measure of quality of life as well as a potential screening tool for depressive symptoms. Future research efforts should focus on validation of the ORS with larger and more diverse clinical samples.

Dietary Polyphenol Intake and Depression: Results from the Mediterranean Healthy Eating, Lifestyle and Aging (MEAL) Study.

Background: The epidemiological evidence for a relation between dietary polyphenol intake and depression is limited. Therefore, the aim of this study was to assess the association between habitual dietary intake of total polyphenols, their classes, subclasses and individual compounds and depressive symptoms among the participants of the Mediterranean healthy Eating, Lifestyle and Aging (MEAL) study. Methods: Demographic and dietary characteristics of 1572 adults living in southern Italy were analyzed. Food frequency questionnaires and Phenol-Explorer were used to calculate habitual dietary intakes of polyphenols. The Center for Epidemiologic Studies Depression Scale (CES-D-10) was used as screening tool for depressive symptoms. Multivariate logistic regression analyses were used to test associations and were expressed as odds ratio (OR) and 95% confidence intervals (CI). Results: A total of 509 individuals reported having depressive symptoms. Based on multivariate logistic regression analyses, total polyphenol intake was not associated with depressive symptoms. After adjustment for potential confounding factors, dietary intake of phenolic acid (OR = 0.64, 95% CI: 0.44, 0.93), flavanones (OR = 0.54, 95% CI: 0.32, 0.91), and anthocyanins (OR = 0.61, 95% CI: 0.42, 0.89) showed significant inverse association with depressive symptoms, when comparing the highest with the lowest quartile. Moreover, flavanones and anthocyanins, were associated with depressive symptoms in a dose-response manner. Among individual compounds, inverse association was observed for quercetin (OR = 0.53, 95% CI: 0.32, 0.86) and naringenin (OR = 0.51, 95% CI: 0.30, 0.85), for the highest versus lowest quartile of intake. When taking into consideration the major sources of the polyphenols, only citrus fruits and wine consumption was inversely associated with depressive symptoms (Q4 vs. Q1: OR= 0.51, 95% CI: 0.35, 0.75; Q4 vs. Q1: OR = 0.53, 95% CI: 0.38, 0.74, respectively). Conclusions: Higher dietary intake of flavonoid may be inversely associated with depressive symptoms. Further studies are needed to definitively confirm these observed associations.

A simple risk score based on sleep quality for predicting depressive symptoms in menopausal women: a multicenter study

ABSTRACTObjective: We aim to establish a simple risk score based on sleep quality for predicting depressive symptoms in menopausal women through a cross-sectional investigation.Materials and methods: A total of 705 Chinese women aged 40–60 years were included in this cross-sectional investigation of a self-report questionnaire from the Physical Examination Center at Shanghai Jiao Tong University Affiliated Sixth People’s Hospital. Depressive symptoms and sleep quality were evaluated using self-rating depressive symptom scale (SDS)and the Pittsburgh Sleep Quality Index (PSQI), respectively. After setting up a logistic regression model and computing the odds ratio value, we further calculated and predicted the risk score for depressive symptoms and then established a risk score system. Finally, we validated the risk score in two investigations (Validation 1 and Validation 2).Results: The risk scoring system for predicting depressive symptoms included a history of cancer, subjective sleep quality, sleep disorder and daytime dysfunction, with total scores ranging from 0–35 points. The receiver operating characteristic (ROC) sample curve was 0.801 (95% CI 0.753–0.848). The Area Under the Curve (AUC) was 0.832 (95% CI 0.738–0.925) in Validation 1 and 0.799 (95%CI 0.667–0.930) in Validation 2. The best cutoff point for depressive symptoms in the sample population was ≥8 points, and the sensitivity and specificity were 0.698 and 0.824, respectively. The sensitivity was 0.775 and 0.667 in Validation 1 and Validation 2, respectively.Conclusions: The risk score for predicting depressive symptoms in menopausal women based on sleep is convenient. Because there is no complex assessment of multiple scales requiredIt may be a preliminary screening tool for depressive symptoms in menopausal women.

Prediction of risk of depressive symptoms in menopausal women based on hot flash and sweating symptoms: a multicentre study.

ObjectiveThe present study aimed to develop a symptom-based (namely, hot flashes and sweating) scoring system for predicting the risk of depressive symptoms in menopausal women via a multicentre cross-sectional survey.MethodsThe data examined in the present study were obtained from 1,004 women aged 40–60 years who underwent physical examination at A Hospital. The basic information was obtained using a questionnaire-based survey. A self-rating depression scale was used to obtain the depressive symptom scores, while the Kupperman Menopausal Index was used to obtain the scores for the frequency of hot flashes and sweating. A logistic regression model was also established. The resulting β coefficient was employed to calculate and predict the risk of depressive symptoms in these women and a risk scoring system was established. The scoring system was validated using samples from 2 other centers (validation sample 1: B Hospital, 440 women; validation sample 2: C Hospital, 247 women).ResultsThe scoring system developed to predict the risk of depressive symptoms in menopausal women was based on hot flash and sweating symptoms and associated with menopausal status, hot flash scores, education level (high school education and below) and being diabetic. The scoring system yielded a total score of 0–54 points. For women in the study sample, the area under the curve (AUC) of depressive symptom risk score was 0.750 (95% CI, 0.708–0.793). Validation sample 1 had an AUC of 0.731 (95% CI, 0.667–0.794), while validation sample 2 had an AUC of 0.744 (95% CI, 0.669–0.820). The optimal cut-off score to assess depressive symptoms in women participating in the present study was 31 points. The sensitivity and specificity for predicting depressive symptoms in the study sample were 0.667 and 0.701, respectively. In contrast, the sensitivity was 0.840 in validation sample 1 and 0.879 in validation sample 2.ConclusionThe hot flash and sweating symptom-based scoring system developed to predict the risk of depressive symptoms in menopausal women relies on non-laboratory survey data. The system is simple, practical, and convenient to use. For Chinese huge population of menopausal women, the scoring system should be considered a reliable screening tool for depressive symptoms.

Epidemiological evaluation of the Patient Health Questionnaire-2 in a pregnant population

IntroductionThe Patient Health Questionnaire-2 (PHQ-2) is a commonly used 2-item screening tool for depressive symptoms among pregnant women in primary care settings. However, its validity has not been assessed for large-scale epidemiological studies. Therefore, the aim of this study was to provide an epidemiological evaluation of the PHQ-2 among pregnant women. MethodA total of 3033 pregnant women participating in the PRegnancy and Infant DEvelopment Study completed the PHQ-2 as well as the Hospital Anxiety Depression Scale-Depression (HADS-D) or the Edinburgh Depression Scale (EDS) three times throughout pregnancy. The validity of the PHQ-2 was assessed with the HADS-D/EDS as reference standard. ResultsSensitivity and specificity of the PHQ-2 were 69–84% and 79–84%, respectively. The positive predictive values (range 19–26%) were substantially lower than the negative predictive values (96–99%). ConclusionDespite the relatively high number of false-positive screens, initial screening for depression by two questions only may enhance routine evaluation of depressive symptoms among pregnant women.

The Patient Health Questionnaire-9 as a Screening Tool for Depression in Individuals with Type 2 Diabetes Mellitus: The Maastricht Study.

To assess the psychometric properties and identify the best cutoff value of the Patient Health Questionnaire-9 (PHQ-9) for depression screening in individuals with type 2 diabetes mellitus (T2DM). Observational population-based cohort study. The Maastricht Study. Individuals with and without T2DM (mean age 58.6 ± 8.1, 44.6% male) according to an oral glucose tolerance test (N = 2,997). Depressive disorder and depressive symptoms were measured using the Mini-International Neuropsychiatric Interview (MINI) as the reference and the PHQ-9. Cronbach alpha, Cohen's kappa and receiver operating characteristic (ROC) analyses were used. Differences in factorial structure between participants with and without T2DM were tested using multigroup confirmatory factor analysis. Based on the traditional PHQ-9 cutoff value, 133 (4.4%) participants had depressive symptoms (PHQ-9 score ≥10). Internal consistency of the PHQ-9 was good (Cronbach α = 0.87 with T2DM, 0.82 without T2DM), the kappa of agreement between the PHQ-9 and the MINI was moderate (0.40 with T2DM, 0.43 without T2DM). Area under the ROC curve for the PHQ-9 was 0.87 in participants with T2DM and 0.88 in those without. A PHQ-9 cutoff score of 5 provided the best sensitivity (92.3%), with acceptable specificity (70.4%), for T2DM, similar to sensitivity and specificity in individuals without T2DM. Factor analysis suggested a similar two-factor structure in both groups (affective and somatic symptoms). Patient Health Questionnaire-9 performs well as a screening tool for depressive symptoms in individuals with and without T2DM based on the cutoff value of 5, indicating that the PHQ-9 can be used in two-stage screening in primary care to select individuals with T2DM for further psychological evaluation.

Development and validation of the NDDI-E-Y: a screening tool for depressive symptoms in pediatric epilepsy.

To validate the revised 12-item revised Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y), a self-report screening tool for depressive symptoms tailored to youth ages 12-17 with epilepsy. Youth at two sites completed the NDDI-E-Y during a routine epilepsy visit. Youth at one site also completed the Children's Depression Inventory-2 (CDI-2). Seizure and demographic data were abstracted from the electronic medical record. Exploratory factor analyses were conducted. Internal consistency, area under the curve (AUC), and construct validity were assessed. NDDI-E-Y questionnaires were analyzed for 143 youth. The coefficient for internal consistency for the NDDI-E-Y was 0.92. Factor analyses suggested a one-factor solution with all 12 items loading on the factor. The NDDI-E-Y was positively correlated with the CDI-2 (N = 99). Sensitivity and specificity of the NDDI-E-Y were high. Reliability and construct validity were established for the revised 12-item NDDI-E-Y. The NDDI-E-Y is a brief, free measure of depressive symptoms that can be administered during a routine epilepsy visit.

Validity and reliability of the depression in old age scale (DIA-S) in Iranian older adults

ObjectiveOne of the most common geriatric psychiatric syndromes is depression. The aim of this study was to assess the validity and reliability of the Depression in Old Age Scale (DIA-S) as a self-report screening tool for depressive symptoms in Iranian elders. MethodsThe population sample was consisted of 210 older subjects admitted to Hamadan adult day care centers. The DIA-S and a socio-demographic questionnaire were used to gather the data. Concurrent and convergent validity were assessed by Geriatric Depression Scale (GDS-15), and Abbreviated Mental Test score (AMTs), respectively. Measures for internal consistency were calculated with Cronbach's alpha. Factor structure of DIA-S was evaluated by principal component analysis, using varimax rotation with Kaiser normalization. Test-retest reliability was carried out using re-administration DIA-S to 24 participants after a gap of 16days. Independent t-test and ANOVA were used to assessing significance of differences across demographic groups. ResultsThe mean score of DIA-S was 3.69 (SD: 1.92, Range: 1–9). The Cronbach’s α for DIA-S score was 0.821, indicating a high degree of internal consistency and homogeneity between the DIA-S items. Test-retest correlation on the 24 patients showed excellent results (ranging from 0.748 to 0.946). Factor analysis revealed one component that confirmed the theoretical construction of the scale. Based on the results, statistically significantly higher DIA-S scores with lower incomes were found. ConclusionsThe DIA-S is a valid and reliable self-report screening tool for depressive symptoms in Iranian geriatric population and may be used in clinical and epidemiological studies.

The latent factors of depression from the short forms of the CES-D are consistent, reliable and valid in community-living older adults

BackgroundDepression is an important public health outcome in the older adult population. It is associated with declining physical and psychological well-being and increasing healthcare utilisation. The Center for Epidemiological Studies Depression Scale (CES-D) although widely accepted as a screening tool for depressive symptoms in older adults, can be long and exhaustive as part of a comprehensive geriatric assessment. AimWe investigated the consistency, reliability and validity of the original and three short formats of the CES-D. MethodsSix thousand six hundred and thirty-seven community-living adults, aged ≥50years from The Irish Longitudinal Study on Ageing (TILDA), completed the 20-item CES-D. Confirmatory factor analysis determined the factor structures of the 20-, 10- and two 8-item formats of the CES-D. Latent factors from each format were validated against disability and perceived stress, particularly the Positive Affect factor. Analysis was also performed in a subset aged 65+years. ResultsAll formats of the CES-D displayed good internally consistency (0.87–0.72) and good model fit for the expected four- and three-factor structures of the CES-D. Latent factors from all formats were representative of each other and the Positive Affect factor was negatively correlated with disability and perceived stress on all CES-D formats. ConclusionShort forms of the CES-D are consistent, reliable and valid for use in the older adult population (50+ or 65+years), where avoiding long assessments and response fatigue is warranted. These formats may be used to measure Positive Affect, an important construct related to physical health, resilience and psychological well-being in later life.

Screening for depression with the Patient Health Questionnaire-2 (PHQ-2) among the general population in Hong Kong

This study investigates the psychometric properties of the Patient Health Questionnaire-2 (PHQ-2) in the general population of Hong Kong. Random sampling was used to recruit 6028 participants aged 15 years or over. Among them, 203 were surveyed twice within a two-week period. Participants completed the Chinese version of the PHQ-9 (including 2 items of the PHQ-2), the Chinese Health Questionnaire, the Happiness Scale, the SF-12, and questions about diagnosis and health service utilization. Internal consistency, test-retest reliability, construct and discriminant validity of the PHQ-2 were assessed. Cronbach's α was 0.76. The test-retest reliability over two weeks calculated by intraclass correlation was 0.70. Spearman correlation results showed that the PHQ-2 score was associated with the remaining seven items of the PHQ-9 (r = 0.53), the Chinese Health Questionnaire (r = 0.37), and the Happiness scale (r = -0.32). As expected, the strength of the correlation between the PHQ-2 and the SF-12 Physical Component Summary was lower (r = -0.29) than that with the SF-12 Mental Component Summary (r = -0.50). Participants with higher PHQ-2 scores more frequently reported having received a depression diagnosis made by a doctor, having chronic illness, using medicine, and utilizing health services. Using the cutoff point ≥ 3, 4.2% of participants screened positive for Major Depressive Disorder. We did not use diagnostic interviews or other depression measures to test the PHQ-2's relative performance in screening for depression. This study provides evidence for the PHQ-2 as a reliable and valid screening tool for depressive symptoms among a randomly recruited community sample in Hong Kong.

Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment?

To determine the reliability of the 30-item Geriatric Depression Scale (GDS-30) for the screening of depressive symptoms in dementia and mild cognitive impairment (MCI) using the Cornell Scale for Depression in Dementia (CSDD) as the 'gold standard'. Diagnosed according to strictly applied clinical diagnostic criteria, patients with MCI (n = 156) and probable Alzheimer's disease (AD) (n = 247) were included. GDS-30, CSDD, Mini Mental State Examination (MMSE) and Global Deterioration Scale were assessed in all patients at inclusion. The AD group was divided in three subgroups: mild AD (MMSE>or=18) (n = 117), moderate AD (MMSE< 18 and >or=10) (n = 89) and severe AD (MMSE<10) (n = 38). In MCI patients, moderate but highly significant correlations were found between GDS-30 and CSDD scores (Pearson: r = 0.565; p < 0.001). In mildly (r = 0.294; p = 0.001), moderately (r = 0.273; p = 0.010) and severely (r = 0.348; p = 0.032) affected AD patients, only weak correlations between GDS-30 and CSDD scores were calculated. ROC curve analysis showed that sensitivity and specificity values of respectively 95% and 67% were achieved when a GDS-30 cut-off score of 8 was applied in MCI patients. In AD patients, too low sensitivity and specificity values did not allow selecting an optimal cut-off score by means of ROC curve analysis. Using the CSDD as 'gold standard', we demonstrated that the GDS-30 is a reliable screening tool for depressive symptoms in MCI but not in AD patients.

O2-07-02: Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment?

SUMMARY Objective To determine the reliability of the 30-item Geriatric Depression Scale (GDS-30) for the screening of depressive symptoms in dementia and mild cognitive impairment (MCI) using the Cornell Scale for Depression in Dementia (CSDD) as the ‘gold standard’. Methods Diagnosed according to strictly applied clinical diagnostic criteria, patients with MCI (n ¼ 156) and probable Alzheimer’s disease (AD) (n ¼ 247) were included. GDS-30, CSDD, Mini Mental State Examination (MMSE) and Global Deterioration Scale were assessed in all patients at inclusion. The AD group was divided in three subgroups: mild AD (MMSE� 18) (n ¼ 117), moderate AD (MMSE< 18 and � 10) (n ¼ 89) and severe AD (MMSE<10) (n ¼ 38). Results In MCI patients, moderate but highly significant correlations were found between GDS-30 and CSDD scores (Pearson: r ¼ 0.565; p < 0.001). In mildly (r ¼ 0.294; p ¼ 0.001), moderately (r ¼ 0.273; p ¼ 0.010) and severely (r ¼ 0.348; p ¼ 0.032) affected AD patients, only weak correlations between GDS-30 and CSDD scores were calculated. ROC curve analysis showed that sensitivity and specificity values of respectively 95% and 67% were achieved when a GDS-30 cut-off score of 8 was applied in MCI patients. In AD patients, too low sensitivity and specificity values did not allow selecting an optimal cut-off score by means of ROC curve analysis. Conclusion Using the CSDD as ‘gold standard’, we demonstrated that the GDS-30 is a reliable screening tool for depressive symptoms in MCI but not in AD patients. Copyright # 2009 John Wiley & Sons, Ltd.