[Design and validation of a questionnaire for the detection of major depression in elderly patients].
OBJECTIVE
The aim of this study was to design and validate a scale to detect major depressive disorders in elderly individuals in primary care (Detection of Depression in the Elderly Scale [DDES]).


METHODS
We performed an observational and cross-sectional study for the validation of a scale, administered by means of a personal interview, in 259 patients aged 65 years old or older. Available instruments were reviewed and the questions were designed. Subsequently, a first pilot study was performed. In a second pilot study the reproducibility of the instrument was analyzed. The gold standard was the result of a standardized psychiatric interview performed by psychiatrists (DSM-IV criteria and SCAN interviews).


RESULTS
The intraclass correlation coefficients corresponding to the test-retest and inter-rater reliability were 0.858 (95% confidence interval [CI], 0.634-0.946) and 0.908 (95% CI, 0.726-0.969) respectively. Two hundred sixteen subjects underwent an assessment, in which primary care and psychiatric evaluations were blinded. Major depression was diagnosed in 81 patients (37.5%; 95% CI, 31.1-44.4). The internal consistency of the DDES was good (Cronbach's alpha = 0.79). Exploratory factorial analysis revealed an 8-component structure (55.8% of explained variance). A cutoff score of 15 or more for the DDES showed sensitivity of 90.1% (95% CI, 80.95-95.33), specificity of 74.8% (95% CI, 66.48-81.71) and a likelihood ratio (+) of 3.58 (95% CI, 2.65-4.83).


CONCLUSIONS
The DDES is a clinically useful instrument for the detection of major depression in elderly patients in primary care.
López-Torres-Hidalgo
Jesús D
JD
Facultad de Medicina. Universidad de Castilla-La Mancha, Albacete, Spain. jesusl@sescam.org
Galdón-Blesa
M Pilar
MP
Fernández-Olano
Clotilde
C
Escobar-Rabadán
Francisco
F
Montoya-Fernández
Julio
J
Boix-Gras
Clotilde
C
Montes-Lozano
María J
MJ
Blas-Hernández
Luís Víctor
LV
Cremades-Romero
María L
ML
Del Campo-Del Campo
José M
JM
Arnalich-Fernández
Francisco
F
D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D015588:Observer Variation; D010865:Pilot Projects; D011320:Primary Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires