Validation and comparison of three brief depression scales in an elderly Chinese population

The study aimed to establish the diagnostic accuracy of the, Geriatric Depr ession Scale (GDS), the Even Briefer Assessment Scale for Depression (EBAS DEP), and the single question test for depression in our elderly Chinese po pulation, and to determine if any one instrument was to be preferred. Ninet y-eight community-living, socially active and non-depressed elderly and 75 patients diagnosed with depression were administered the three depression s cales. Receiver operating characteristics (ROC) were employed to determine the optimal cut-off scores for the GDS and EBAS DEP, and the diagnostic per formance of all three instruments were then compared. ROC ana lysis indicat ed an optimal cut-off score of 4 and above for the 15-item GDS, with a sens itivity of 84.0% and a specificity of 85.7%, while the EBAS DEP had 77.3% s ensitivity and 89.8% specificity at the optimal cut-off score of 3 and abov e. The sensitivity and specificity of the single question were 64.0% and 94 .9%, respectively. The non-parametric test of the arras-under-thr-curve sho wed no significant difference between the diagnostic performances of the GD S and the EBAS DEP: visually, however, the ROC plot of the GDS was superior . The GDS. the EBAS DEP, and the single question were all valid screening t ools for depression in the elderly Chinese population. For busy physicians, there is rationale to first use the single-question test, supplemented whe re necessary with either the GDS or the EBAS DEP, as an efficient diagnosti c strategy for identifying depression amongst older Chinese patients. Copyr ight (C), 2000 John Wiley & Sons, Ltd.