Performance of a single screening question for depression in a representative sample of 13 670 people aged 75 and over in the UK: results from the MRC trial of assessment and management of older people in the community.
BACKGROUND
A concise, accurate screening question for depression would be an important contribution to the Single Assessment Process for Older People.


OBJECTIVE
To examine the performance of a previously validated screening question for depression, in a large community sample.


METHODS
Both the single screening question, and the Geriatric Depression Scale (GDS-15) were completed by 13 670 people aged 75 and over in the community. Responses to the question were compared with a "standard" of scoring above different thresholds on the Geriatric Depression Scale (GDS-15).


RESULTS
For more severe GDS-15 depression, the best performance of the question was a sensitivity of only 52% and a specificity of 93%.


CONCLUSIONS
Even at its best, the question therefore misses almost half the cases. This highlights the problems of such simple approaches to routine screening.
Osborn
David P J
DP
Department of Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. dosborn@rfc.ucl.ac.uk
Fletcher
Astrid E
AE
Smeeth
Liam
L
Stirling
Susan
S
Bulpitt
Christopher J
CJ
Nunes
Maria
M
Breeze
Elizabeth
E
Ng
Edmond S W
ES
Jones
Dee
D
Tulloch
Alistair
A
D000368:Aged; D016001:Confidence Intervals; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology