An evaluation of two self-report screening measures for mood in an out-patient chronic heart failure population.
OBJECTIVE
To examine the criterion validity of the Hospital Anxiety and Depression Scale (HADS) and the Geriatric Depression Scale 15-item (GDS-15) in a community sample of Chronic Heart Failure (CHF) out-patients.


METHODS
Eighty-eight of 203 older adults with confirmed CHF responded to a postal survey and participated in a face-to-face interview. The GDS-15 and HADS were compared to diagnoses from the Structured Clinical Interview for DSM-IV (SCID-I), using a receiver operating characteristic (ROC) analysis and positive and negative predictive values, sensitivity and specificity for various cut-off points.


RESULTS
For all depressive disorders, the area under the ROC curve for the GDS-15 was 0.883 and a cut-off of 5 gave a sensitivity of 0.818 and a specificity of 0.833. The area under the ROC curve for the HADS Depression (D) and Anxiety (A) were 0.889 and 0.941 respectively. At a cut-off of 7, the HADS-A gave a sensitivity of 0.938 and a specificity of 0.847. At a cut-off of 4, the HADS-D gave a sensitivity of 0.864 and a specificity of 0.788.


CONCLUSIONS
The GDS-15 and HADS are valid screening tools for detecting depression in aged CHF out-patients. However, use of the HADS requires reduced cut-points to ensure that patients with mood disorder are not missed in this population.
Haworth
J E
JE
Department of Clinical and Health Psychology, St James's University Hospital, Leeds, UK. Jane.Haworth@leedsth.nhs.uk
Moniz-Cook
E
E
Clark
A L
AL
Wang
M
M
Cleland
J G F
JG
D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity