Accuracy of three depression screening scales to diagnose major depressive episodes in older adults without neurocognitive disorders

Abstract

Objective: To determine the sensitivity and specificity of three depression screening scales to diagnose major depressive episodes in the elderly. Methods: Participants (n=129, 88% female) answered a semi-structured psychiatric interview (Mini International Neuropsychiatric Interview) to determine the diagnosis of major depressive disorder. After this, depressive symptoms in depressed and non-depressed subjects were assessed by independent administration of the 15-item Geriatric Depression Scale (GDS-15), Patient Health Questionnaire-9 (PHQ-9), and 17-item Hamilton Rating Scale for Depression (HDRS-17). Results: Patients with major depression and controls did not differ in age and gender distribution. The sensitivity and specificity of all scales to identify a major depressive episode in older adults were ≥ 90%. There were no significant differences between the areas under the curve for PHQ-9 vs. HDRS-17 (z = 1.2, p = 0.2), PHQ-9 vs. GDS-15 (z = 0.26, p = 0.8), or HDRS-17 vs. GDS-15 (z = 1.2, p = 0.2). Conclusion: This study provides evidence supporting the use of PHQ-9 and GDS-15, both of which are simple to administer and easy to interpret, to diagnose major depressive episodes in older adults without neurocognitive disorders.

Keywords

• Late-life depression
• diagnosis
• screening
• geriatric assessment