title: Usefulness of a single-item measure of depression to predict mortality: the GAZEL prospective cohort study.
abstract: BACKGROUND
  It remains unknown whether short measures of depression perform as well as long measures in predicting adverse outcomes such as mortality. The present study aims to examine the predictive value of a single-item measure of depression for mortality.
  
  
  METHODS
  A total of 14,185 participants of the GAZEL cohort completed the 20-item Center-for-Epidemiologic-Studies-Depression (CES-D) scale in 1996. One of these items (I felt depressed) was used as a single-item measure of depression. All-cause mortality data were available until 30 September 2009, a mean follow-up period of 12.7 years with a total of 650 deaths.
  
  
  RESULTS
  In Cox regression model adjusted for baseline socio-demographic characteristics, a one-unit increase in the single-item score (range 0-3) was associated with a 25% higher risk of all-cause mortality (95% CI: 13-37%, P<0.001). Further adjustment for health-related behaviours and physical chronic diseases reduced this risk by 36% and 8%, respectively. After adjustment for all these variables, every one-unit increase in the single-item score predicted a 15% increased risk of death (95% CI: 5-27%, P<0.01). There is also an evidence of a dose-reponse relationship between reponse scores on the single-item measure of depression and mortality.
  
  
  CONCLUSIONS
  This study shows that a single-item measure of depression is associated with an increased risk of death. Given its simplicity and ease of administration, a very simple single-item measure of depression might be useful for identifying middle-aged adults at risk for elevated depressive symptoms in large epidemiological studies and clinical settings.
authors.affiliation: INSERM, U1018, Centre for research in Epidemiology and Population Health, Epidemiology of occupational and social determinants of health, F-94807, Villejuif, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lefèvre
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.forename: Silvia
authors.initials: S
authors.lastname: Stringhini
authors.forename: Aline
authors.initials: A
authors.lastname: Dugravot
authors.forename: Cédric
authors.initials: C
authors.lastname: Lemogne
authors.forename: Silla M
authors.initials: SM
authors.lastname: Consoli
authors.forename: Marcel
authors.initials: M
authors.lastname: Goldberg
authors.forename: Marie
authors.initials: M
authors.lastname: Zins
authors.forename: Hermann
authors.initials: H
authors.lastname: Nabi
mesh_terms: D000328:Adult; D002423:Cause of Death; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires