title: Validation of a brief screening tool to detect depression in elderly ED patients.
abstract: Although depression is the most common psychiatric disorder in the elderly, it is often unrecognized by physicians. The objective of the study was to assess the utility of a 3-question screening instrument (ED-DSI) to detect depression among elderly emergency department (ED) patients. We used a prospective convenience sample of English-speaking ED patients >or=65yr. Patients were excluded for being too ill to participate, having obvious dementia, or acute changes in mentation. A physician administered the ED-DSI. Trained research personnel blinded to ED-DSI answers then administered the 30 question Geriatric Depression Scale (GDS). The ED-DSI was considered positive if the patient answered yes to one or more questions and subjects were considered depressed when the GDS score was >or=10. ED-DSI was compared to GDS using contingency tables. A total of 103 subjects were enrolled. Average age was 75 years and subjects were predominately female (66%) and white (85%). GDS identified 33 patients (32%) as depressed. Of these, 26 were correctly identified by ED-DSI giving an ED-DSI sensitivity of 79% (95%CI (65%, 93%)) specificity of 66% (95%CI (54%, 78%)) and a negative predictive value of 87% (95%CI (79%, 95%)). The 3-question ED-DSI is a useful tool to detect depression in this population of ED patients.
authors.affiliation: Department of Medicine, Albany Medical College, Albany, NY 12208, USA.
authors.forename: Diana A
authors.initials: DA
authors.lastname: Fabacher
authors.forename: Nancy
authors.initials: N
authors.lastname: Raccio-Robak
authors.forename: Mara A
authors.initials: MA
authors.lastname: McErlean
authors.forename: Peter M
authors.initials: PM
authors.lastname: Milano
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Verdile
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008487:Medical History Taking; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires