Screening for depression in nursing home palliative care patients.
The purpose of the this study was to evaluate the existing tools for assessing depression in nursing home patients referred to palliative care services. The patients referred to palliative care were assessed for depression by a geriatric fellow and a psychiatrist (gold standard). The questions asked by the fellow were derived from the existing validated screening scales and diagnostic tools. The psychiatrist's assessment had a strong agreement with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; kappa = 0.400) and Geriatric Depression Scale (GDS; kappa = 0.462) and least agreement with the Cornell Scale for Depression in Dementia (CDS). However, depression in the most severe dementia patients (Mini-Mental State Examination = 0) was able to be assessed only by the CDS. Thus, although items from the DSM-IV and GDS may be used to ascertain depression in geriatric patients, to date there is no scale valid and reliable enough to effectively ascertain depression in the most severely demented patients.
Greenberg
Loren
L
Department of Geriatrics, Mount Sinai Medical Center, New York, New York, USA.
Lantz
Melinda S
MS
Likourezos
Antonios
A
Burack
Orah R
OR
Chichin
Eileen
E
Carter
John
J
D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009735:Nursing Homes; D010166:Palliative Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires