Brief reportCan the Geriatric Depression Scale detect poststroke depression in Chinese elderly?
Introduction
Post-stroke depression (PSD) is common in Chinese stroke patients with a prevalence ranging from 17 to 62.2% (Zhang, 1992, Fuh et al., 1997, Chan et al., 1995, Tang et al., 2002). To date, however, screening for PSD in Chinese patients has received little attention in the literature.
The Geriatric Depression Scale (GDS) has been used to detect PSD in Caucasian patients in acute inpatient and rehabilitation settings (Schubert et al., 1992, Diamond et al., 1995). GDS performed well as a screening instrument in Caucasian patients with stroke (Argell and Dehlin, 1989, Johnson et al., 1995).
The Chinese version of GDS is a reliable and valid instrument (Chiu et al., 1994a, Lai, 2000), which has been employed in detecting depression among Chinese stroke survivors in the community (Fuh et al., 1997). To our knowledge, there has been no study examining the performance of GDS as a screening instrument for PSD in a Chinese geriatric stroke population.
The aim of this study was to determine the optimal cut-off point, sensitivity, specificity, positive and negative predictive values and the area under the receiver operating characteristic (ROC) curve of the 15-item Chinese version of GDS (Lim et al., 2000), as a screening instrument for PSD in Chinese geriatric stroke patients.
Section snippets
Methods
Participants in the study were patients in the Acute Stroke Unit of Prince of Wales Hospital (PWH) who were consecutively admitted with first-ever or recurrent stroke over a period of 6 months. PWH is a general hospital serving a population of 800,000 in Hong Kong. Inclusion criteria were: (1) Chinese ethnicity; (2) age ≥65 years; (3) well-documented (clinical presentation and CT and/or MRI scan of the brain) first or recurrent acute stroke occurring within 7 days prior to admission; (5)
Results
Recruitment of subjects took place from January to July 2002. Two hundred and ninety-three patients (>65 years) with acute stroke were admitted to PWH during this period. Altogether, 166 (56.7%) patients were excluded from the study; their demographic and clinical characteristics are shown in Table 1. When compared to the study sample, excluded patients were older, more likely to be female and had a higher pre-stroke Modified Rankin Score (van Swieten et al., 1988) and National Institute of
Discussion
This investigation was carried out in a cohort of Chinese elderly with stroke. There is no conclusive evidence concerning the role of ethnicity in ascertaining PSD (Tang et al., 2002). Since the Chinese versions of GDS, MMSE and SCID-DSM-IV used in the study are properly validated instruments, our results are likely to be applicable to stroke patients of other ethnic background.
The main limitation of the study shared by most investigations in this field is the high attrition rate resulting in a
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