Screening for Depression among Community-dwelling Elders: Usefulness of the Center for Epidemiologic Studies Depression Scale.
BACKGROUND
Though common, depressive disorders often remain undetected in late life.


OBJECTIVE
To examine the usefulness of Center for Epidemiologic Studies Depression (CES-D) for identifying depression among older people.


METHODS
Community resident older people (aged 65 years or more), were evaluated by clinicians trained in psychiatry, as part of a cross-sectional study of late-life depression. Assessments were done in the community.


METHODS
The participants were assigned ICD-10 diagnoses and assessed using Montgomery-Asberg Depression Rating Scale (MADRS) and CES-D. A short version of CES-D with 10 items, translated to the local language Malayalam, was used.


METHODS
The sensitivity and specificity of CES-D was evaluated against ICD-10 clinical diagnosis of depression. The correlation of CES-D and MADRS was assessed using Pearson correlation coefficient.


RESULTS
220 consenting adults from 3 wards of the Panchayath were assessed. On analysis of the Receiver Operating Characteristic (ROC) curve of CES-D scores in relation to clinical diagnosis, the large Area Under Curve (AUC) showed efficient screening and a cut off score of 4 in CES-D had a sensitivity of 97.7% and a specificity of 79.1% for depression. There was also good correlation between the MADRS and CES-D scores (0.838).


CONCLUSIONS
CES-D is a short simple scale which can be used by health care professionals for detecting depression in older people in primary care settings.
Department of Psychiatry, Government Medical College, Thrissur, Kerala, India.
Sebind
S
Kumar
Department of Psychiatry, Daya Hospital, Thrissur, Kerala, India.
Anisha
A
Nakulan
Department of Psychiatry, Government Medical College, Alappuzha, Kerala, India.
Sumesh Purushothaman
SP
Thoppil
Department of Psychiatry, Government Medical College, Thrissur, Kerala, India.
Rejani Parameshwaran
RP
Parassery
Department of Psychiatry, Government Medical College, Thrissur, Kerala, India.
Shaji Sivaraman
SS
Kunnukattil
Center for Epidemiologic Studies Depression Scale; community-resident elderly; depression; screening