Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale.
Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale.
复制标题
评估简化版老年抑郁量表的可行性、可靠性和诊断价值。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
J. Mulder
中科院分区：
文献类型：
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作者：
H. V. Marwijk;P. Wallace;G. H. D. Bock;J. Hermans;A. Kaptein;J. Mulder
背景
人们已经开发了许多量表来评估抑郁症，但它们往往太长，无法在全科咨询中实际使用。
目的
进行了一项研究，以调查老年抑郁量表及其较短版本在一般实践中筛查的可行性、可靠性和诊断价值。
方法
荷兰西部 9 个全科诊所（13 名医生）连续对 586 名 65 岁及以上的咨询患者进行了研究。将 30 项版本的老年抑郁值与诊断访谈时间表进行比较，作为参考测试。
结果
参考测试显示 6 名患者患有重度抑郁症，而 27 名患者患有心境恶劣障碍（即慢性轻度抑郁症）。 5% 的患者需要帮助解决老年抑郁量表中 50% 的问题。 30 项、15 项、10 项和 4 项版本的诊断价值没有显着差异，但 1 项版本的表现并不比机会更好。有两项能够最好地区分抑郁症患者和非抑郁症患者（P < 0.05），其中只有一项包含在先前提出的四项量表版本中。所提出的四项版本的可靠性为 0.64，其他版本的可靠性范围为 0.70 至 0.87。
结论
不同版本老年抑郁量表的结果建议使用 10 项目或 4 项目版本。出于实际目的，最小的子集将是最理想的：四项版本。这些量表可能更适合排除而不是包容的目的。根据研究结果讨论了在一般实践环境中筛查老年人抑郁症的可行性。
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 feasibility, reliability and diagnostic value of the geriatric depression scale 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 value was compared with the diagnostic interview schedule as a reference test.
RESULTS
The reference test indicated a major depression in six patients while 27 patients had a dysthymic disorder (that is, a chronic mild depression). Five per cent of patients required help for 50% of the questions on the geriatric depression scale. The diagnostic value of the 30-item, 15-item, 10-item and four-item versions did not differ significantly, but the one-item version performed no better than chance. Two items discriminated best between patients who were and who were not depressed (P < 0.05), only one of which was included in a previously proposed four-item version of the scale. The reliability of the proposed four-item version was 0.64, the reliability of the other versions ranging from 0.70 to 0.87.
CONCLUSION
The results for the different versions of the geriatric depression scale suggest the use of a 10-item or a four-item version. For practical purposes, the smallest subset would be the most desirable: the four-item version. These scales may be better suited for exclusion rather than inclusion purposes. The feasibility of screening for depression in elderly people in a general practice setting is discussed in the light of the results of the study.