CULTURALLY SENSITIVE VALIDATION OF SCREENING QUESTIONNAIRES FOR DEPRESSION IN OLDER AFRICAN-CARIBBEAN PEOPLE LIVING IN SOUTH LONDON

Background We tested the validity of two screens for depression in old er African-Caribbean adults. the 15-item Geriatric Depression Scale (G DS) and a new Caribbean Culture-Specific Screen for emotional distress (CCSS). Two independent criteria were used for validity: (a) a psychi atric diagnosis derived from GMS-AGECAT, and (b) a culturally sensitiv e assessment of mental disorder, derived from a tool developed with lo cal African-Caribbean religious healers. Method One hundred and sixty- four consecutive African-Caribbean primary care users, aged 60 years o r older, were screened with the GDS and the CCSS. Diagnostic interview s were carried But on 80% of high scorers and 20% of low scorers.Resul ts The number of cases detected by the two separate diagnostic approac hes was similar. However, the agreement between who was and who was no t a case was only modest. At a cutoff of greater than or equal to 5, t he GDS was an adequate case detector for psychiatric depression, and, at a cut-off of greater than or equal to 4, for 'depressed/lost spirit ', as defined by culture-specific criteria. It performed as well as th e new CCSS. Conclusions At a cut-off of greater than or equal to 4 the 15-item GDS can be recommended as a case detector for significant for ms of depression in older African-Caribbean people living in south Lon don.