EVALUATION OF THE FEASIBILITY, RELIABILITY AND DIAGNOSTIC-VALUE OF SHORTENED VERSIONS OF THE GERIATRIC DEPRESSION SCALE

Background. Many scales have been developed to assess depression, but they are often too lengthy to be of practical use in general practice consultations. Aim. A study was undertaken to investigate the feasibil ity, reliability and diagnostic value of the geriatric depression scal e and its shorter versions for screening in general practice. Method. A total of 586 consecutive consulting patients aged 65 years and over were studied in nine general practices in the west of the Netherlands (13 doctors). The 30-item version of the geriatric depression scale wa s compared with the diagnostic interview schedule as a reference test. Results. The reference test indicated a major depression in six patie nts while 27 patients had a dysthymic disorder (that is, a chronic mil d depression). Five per cent of patients required help for 50% of the questions on the geriatric depression scale. The diagnostic value of t he 30-item, 15-item, 10-item and four-item versions did not differ sig nificantly, but the one-item version performed no better than chance. Two items discriminated best between patients who were and who were no t depressed (P<0.05), only one of which was included in a previously p roposed four-item version of the scale. The reliability of the propose d four-item version was 0.64, the reliability of the other versions ra nging from 0.70 to 0.87. Conclusion. The results for the different ver sions of the geriatric depression scale suggest the use of a 10-item o r a four-item version. For practical purposes, the smallest subset wou ld be the most desirable: the four-item version. These scales may be b etter suited for exclusion rather than inclusion purposes. The feasibi lity of screening for depression in elderly people in a general practi ce setting is discussed in the light of the results of the study.