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Test Characteristics of the 15-Item Geriatric Depression Scale and Hamilton Depression Rating Scale in Parkinson Disease

https://doi.org/10.1097/01.JGP.0000192488.66049.4bGet rights and content

Objective

The objective of this study was to compare the sensitivity, specificity, and diagnostic accuracy of the 15-item Geriatric Depression Scale (GDS-15) and the Hamilton Depression Rating Scale (HDRS) in patients with Parkinson disease (PD).

Method

A convenience sample of 148 outpatients with idiopathic PD receiving specialty care completed the GDS-15 and were administered the HDRS and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID) depression module by a research psychiatrist or trained research assistant. Receiver-operating characteristic (ROC) curves were plotted for the GDS-15 and HDRS scores with a SCID diagnosis of a depressive disorder as the state variable.

Results

Thirty-two subjects (22%) were diagnosed with a depressive disorder. The discriminant validity of the GDS-15 and HDRS were both high (ROC area under the curve: 0.92 and 0.91, respectively), with greatest dichotomization for the GDS-15 at a cutoff of 4/5 (87% accuracy, 88% sensitivity, 85% specificity) and the HDRS at a cutoff of 9/10 (83% accuracy, 88% sensitivity, 78% specificity).

Conclusions

The GDS-15 performs well as a screening instrument and in distinguishing depressed from nondepressed patients in PD. Its test characteristics are comparable to the HDRS. Because it is a brief instrument and can be self-administered, it is an excellent depression screening tool in this population.

Section snippets

Subjects

The study population consisted of a convenience sample of 148 outpatients, all (but two) male, who were new or established patients at the Parkinson's Disease Research, Education and Clinical Center (PADRECC) at the Philadelphia Veterans Affairs Medical Center (PVAMC) or the Parkinson's Disease and Movement Disorders Center (PDMDC) at the University of Pennsylvania. The PVAMC and University of Pennsylvania Institutional Review Boards approved the study, and only patients able to provide

RESULTS

Characteristics of the sample population included: mean age=72.0 years (standard deviation [SD]: 8.5, range: 40–90), MMSE score=27.5 (SD: 2.6, range: 13–30), duration of PD=7.8 years (SD: 5.8, range: 1–25), UPDRS score=24.5 (SD: 11.5, range: 3–60), Hoehn and Yahr stage = 2.3 (SD: 0.6, range: 1–4), and mean daily L-dopa dosage = 440 mg (SD: 322 mg, range: 0–1420 mg). Thirty-two subjects (21.6%) met DSM–IV diagnostic criteria for a depressive disorder (18 [12.2%] with major depression and 14

DISCUSSION

The GDS-15 is a commonly used instrument for depression screening in the general geriatric population and has been piloted for use in PD as well.31 Its clinical use in identifying depressed patients and its usefulness as a research tool for dPD, however, are predicated on the assumption that the GDS-15 is a valid measure of depression in this population. We evaluated the psychometric properties of the GDS-15 against the “gold standard” of DSM–IV criteria for a depressive disorder and compared

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    This study was supported by a grant from National Institute of Mental Health (#K23MH067894).

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