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Validity of the Brazilian version of the Geriatric Depression Scale (GDS) among primary care patients

Published online by Cambridge University Press:  03 November 2009

Milena Sampaio Castelo ,
João M. Coelho-Filho ,
André F. Carvalho ,
José W. O. Lima ,
Jamile C. S. Noleto ,
Kérsia G. Ribeiro  and
José I. Siqueira-Neto
Milena Sampaio Castelo
Affiliation:
University of Fortaleza, Division of Mental Health, Fortaleza, CE, Brazil
João M. Coelho-Filho
Affiliation:
Faculty of Medicine, Federal University of Ceará, Division of Geriatric Medicine, Department of Clinical Medicine, Fortaleza, CE, Brazil
André F. Carvalho
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Clinical Medicine, Fortaleza, CE, Brazil
José W. O. Lima
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Community Health, Fortaleza, CE, Brazil
Jamile C. S. Noleto
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Clinical Medicine, Fortaleza, CE, Brazil
Kérsia G. Ribeiro
Affiliation:
Faculty of Medicine, Federal University of Ceará, Department of Clinical Medicine, Fortaleza, CE, Brazil
José I. Siqueira-Neto*
Affiliation:
Faculty of Medicine, Federal University of Ceará, Division of Cognitive Neurology, Fortaleza, CE, Brazil
*
Correspondence should be addressed to: José Ibiapina Siqueira Neto MD, PhD, Faculdade de Medicine, Universidade Federal do Ceará, Departamento de Medicina Clínica, Rua Prof. Costa Mendes, 1608, 4o andar, 60430-040, Fortaleza, CE, Brazil. Phone: +55-85-33668054; Fax: +55–85-33668052. Email: [email protected].
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Abstract

Background: The aim of the present study was to determine the validity of the Brazilian version of the Geriatric Depression Scale (GDS) with 30 (GDS-30), 15 (GDS-15), 10 (GDS-10), 4 (GDS-4) and 1 (GDS-1) items and to calculate the optimum cutoff points for identifying depression among elderly primary care subjects.

Methods: A cross-sectional study was carried out involving 220 elderly patients recruited from four primary care clinics in northeastern Brazil. The following measurements were obtained: sociodemographic variables, Katz scale of independence in activities of daily living, and the GDS with 30, 15, 10, 4 and 1 item(s). A psychiatrist blinded to the results of the GDS applied the mood module of the Structured Clinical Interview for the DSM-IV for the diagnosis of major depressive episodes as the “gold standard.”

Results: The use of the cut-off point of 10/11 for the GDS-30 produced sensitivity and specificity rates of 92.0% (95% CI: 70–98) and 79% (95% CI: 73–85), respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 49% and 98%, respectively. The optimum cut-off point for the GDS-15 was 4/5, at which sensitivity was 87% (95% CI: 71–95) and specificity was 82% (95% CI: 76–91), PPV was 51% and NPV was 97%. At the cut-off point of 3/4 the sensitivity, specificity, PPV and NPV for the GDS-10 were 76% (95% CI: 60–89), 81% (95% CI: 75–87), 46% (95% CI: 33–59%), and 94% (95% CI 89–97%), respectively. The optimum cut-off point for the GDS-4 was 0/1, at which sensitivity was 84% (95% CI: 68–93%); specificity was 75% (95% CI; 68–91%); PPV was 41% and NPV was 96%. For the GDS-1, sensitivity was 47%, specificity was 96%; PPV was 69% and NPV was 90%.

Conclusions: The GDS-30, GDS-15, GDS-10 and GDS-4 proved to be good screening instruments for depression in primary care clinics in Brazil, whereas the GDS-1 failed to perform adequately.

Keywords

depressionelderlymental healthprimary carescreening
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 1 , February 2010 , pp. 109 - 113
Copyright
Copyright © International Psychogeriatric Association 2009

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