title: [Design and validation of a questionnaire for the detection of major depression in elderly patients].
abstract: 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.
authors.affiliation: Facultad de Medicina. Universidad de Castilla-La Mancha, Albacete, Spain. jesusl@sescam.org
authors.forename: Jesús D
authors.initials: JD
authors.lastname: López-Torres-Hidalgo
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Galdón-Blesa
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fernández-Olano
authors.forename: Francisco
authors.initials: F
authors.lastname: Escobar-Rabadán
authors.forename: Julio
authors.initials: J
authors.lastname: Montoya-Fernández
authors.forename: Clotilde
authors.initials: C
authors.lastname: Boix-Gras
authors.forename: María J
authors.initials: MJ
authors.lastname: Montes-Lozano
authors.forename: Luís Víctor
authors.initials: LV
authors.lastname: Blas-Hernández
authors.forename: María L
authors.initials: ML
authors.lastname: Cremades-Romero
authors.forename: José M
authors.initials: JM
authors.lastname: Del Campo-Del Campo
authors.forename: Francisco
authors.initials: F
authors.lastname: Arnalich-Fernández
mesh_terms: 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