title: Beside the Geriatric Depression Scale: the WHO-Five Well-being Index as a valid screening tool for depression in nursing homes.
abstract: OBJECTIVE
  The aim of the study was to compare criterion validities of the WHO-Five Well-being Index (WHO-5) and the Geriatric Depression Scale 15-item version (GDS-15) and 4-item version (GDS-4) as screening instruments for depression in nursing home residents.
  
  
  METHODS
  Data from 92 residents aged 65-97 years without severe cognitive impairment (Mini Mental State Examination ≥15) were analysed. Criterion validities of the WHO-5, the GDS-15 and the GDS-4 were assessed against diagnoses of major and minor depression provided by the Structured Clinical Interview for DSM-IV. Subanalyses were performed for major and minor depression. Areas under the receiver operating curve (AUCs) as well as sensitivities and specificities at optimal cut-off points were computed.
  
  
  RESULTS
  Prevalence of depressive disorder was 28.3%. The AUC value of the WHO-5 (0.90) was similar to that of the GDS-15 (0.82). Sensitivity of the WHO-5 (0.92) at its optimal cut-off of ≤12 was significantly higher than that of the GDS-15 (0.69) at its optimal cut-off of ≥7. The WHO-5 was equally sensitive for the subgroups of major and minor depression (0.92), whereas the GDS-15 was sensitive only for major depression (0.85), but not for minor depression (0.54). For specificity, there was no significant difference between WHO-5 (0.79) and GDS-15 (0.88), but both instruments outperformed the GDS-4 (0.53).
  
  
  CONCLUSIONS
  The WHO-5 demonstrated high sensitivity for major and minor depression. Being shorter than the GDS-15 and superior to the GDS-4, the WHO-5 is a promising screening tool that could help physicians improve low recognition rates of depression in nursing home residents.
authors: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
authors: Antje-Kathrin
authors: AK
authors: Allgaier
authors: Dietmar
authors: D
authors: Kramer
authors: Barbara
authors: B
authors: Saravo
authors: Roland
authors: R
authors: Mergl
authors: Sabina
authors: S
authors: Fejtkova
authors: Ulrich
authors: U
authors: Hegerl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012680:Sensitivity and Specificity
keywords: ROC curve; aged; depression; diagnosis; nursing homes; sensitivity and specificity