Skip to main content
Article thumbnail
Location of Repository

Screening for depression in older people in the acute general hospital setting: The performance of the Edinburgh Depression Scale (EDS)

By Collins Iheanyichukwu Esiwe

Abstract

Introduction\ud Depression affects approximately 25% of older people in general hospitals, yet it is often undiagnosed and under treated leading to extended lengths of stay and increased morbidity and mortality. Recent UK depression guidelines recommend screening at risk populations such as the physically ill. Several depression screening tools exist, but they include somatic symptoms that are common to both physically ill and depression. Many practitioners also find them cumbersome and time consuming for routine use.\ud Aim\ud The aim of this study is to assess the performance of the EDS as a brief screening tool for depression in older adults in the acute general hospital setting, and compare its performance with the Geriatric Depression Scale (GDS,4-item and 15-item) and the two questions suggested in the NICE depression guidelines (NICE-2; NICE, 2009).\ud Methods\ud 118 eligible older adults under the care of 4 acute medical teams at the Leicester General Hospital between October 2006 and June 2010 were assessed for depression using the Present State Examination – Schedules for Clinical Assessment in Neuropsychiatry (PSE-SCAN; WHO, 1982).Participants were also screened for depression with the EDS, GDS and the two NICE questions .The PSE-SCAN determined ICD-10 diagnosis of depressive episode acted as „gold standard‟. The test characteristics of the screening instruments were calculated at various cut-offs. Receiver Operating Characteristic (ROC) curves enabled comparisons of the various scales and determined the most appropriate cut-off threshold.\ud Results\ud The estimated prevalence of ICD-10 depressive episode was 22%.All scales had comparable sensitivity (80 – 100%), specificity (70 – 86%), and negative predictive values (93-100%).Areas under the ROC curves for the scales were comparable(range 0.85 -0.92) with no statistically significant difference between them.\ud Conclusion\ud The EDS and the two NICE questions performed just as well as other established screening tools and may be utilized in screening for depression in this population

Publisher: University of Leicester
Year: 2011
OAI identifier: oai:lra.le.ac.uk:2381/9886

Suggested articles

Citations

  1. A method of comparing the Areas under Receiver Operating Characteristic Curves derived from the same cases. doi
  2. (2004). A prospective study to compare three depression screening tools in patients who are terminally ill. General Hospital Psychiatry doi
  3. (1989). al: The incidence of specific DIS/DSM-III mental disorders: data from the NIMH Epidemiological Catchment Area program. Acta Psychiatrica Scandinavica doi
  4. (1997). Archives of General Psychiatry doi
  5. (1986). Assessment of depression in an elderly medical population. doi
  6. (1997). Case finding instruments for depression: two questions are as good as many. doi
  7. (2002). Comorbidity of depression with other medical disease in the elderly. Biological Psychiatry doi
  8. (1998). Correlations between scores on Chinese versions of long and short forms of the Geriatric Depression Scale among elderly Chinese. Psychol. Rep doi
  9. (2000). Criterion validation of the Edinburgh Postnatal Depression Scale as a screening tool for depression in patients with advanced metastatic cancer. doi
  10. (2000). Critical Appraisal for psychiatry. Churchill
  11. Depression among elderly residents of local-authority residents‟ homes: its nature and the efficacy of intervention. doi
  12. (2009). Depression in adults with a chronic physical health problem: doi
  13. (1988). Depression in elderly hospitalised patients with medical illness. Arch Internal Med
  14. (1997). Depression in elderly medical inpatients: a meta-analysis of outcomes.
  15. (1999). Depression in Europe. Geographical distribution among older people. doi
  16. Depression in late life, review and commentary. doi
  17. (1997). Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes. doi
  18. (2005). Depression in old age. doi
  19. Depression is a risk factor for non suicide mortality in the elderly. doi
  20. (2009). Depression: the treatment and management of depression in adults (update). doi
  21. (1990). Depressive symptoms and the cost of health services
  22. (1998). Detecting depression in elderly medical inpatients. doi
  23. (1993). Detecting depression in elderly medically ill patients: the use of the Geriatric Depression Scale compared with medical and nursing observations. Age Ageing doi
  24. Development and validation of a geriatric depression screening scale: a preliminary report. doi
  25. (2000). Diagnosis of depression in elderly patients. doi
  26. (2007). Do ultra-short screening instruments accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies.
  27. (2008). Does Depression predict adverse outcomes for older medical inpatients? A prospective cohort study of individuals screened for a trial. Age and Aging doi
  28. (2002). Duration and severity of depression predict mortality in older adults in the community. Psychological Medicine doi
  29. (2006). Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2000 British Association for Psychopharmacology (BAP) guidelines on depression doi
  30. (1988). Increased mortality rates in late-life depression. doi
  31. (1997). Increased rate of psychosis and psychomotor change in depression with age. Psychological Medicine doi
  32. Instruments for screening depression and dementia in a long term care facility. doi
  33. (2006). Maintenance treatment of major depression in old age.
  34. (1995). Major and Minor depression in later life: a study of prevalence and risk factors. J Affect Disord. doi
  35. (2010). Major depression in elderly medical inpatients in Greece, prevalence and identification. Aging Clinical and Experimental Research doi
  36. Managing depression in physical illness. Advances in Psychiatric Treatment 2002; 8:297- 305. MacMillan HL, Patterson CJS, Wathen CN. Screening for depression in primary care: recommendation statement from the Canadian Taskforce on Preventative Health Care.
  37. (1975). Mini-mental state‟. A practical method for grading the cognitive state of patients for the clinician. doi
  38. Mood disorders: depressive disorders in Oxford textbook of Old Age Psychiatry.2008:29ii;
  39. (2009). National Screening Committee UK; Criteria for appraising the viability, effectiveness and appropriateness of a screening programme
  40. (1999). Nortriptyline and interpersonal psychotherapy as maintenance therapies for recurrent major depression: a randomized controlled trial in patients older than 59 years. JAMA doi
  41. (2004). Prevalence of DSM-IV psychiatric disorder in the French elderly population.
  42. (2007). Prevalence of International Classification of Diseases, 10th Revision common mental disorders in a Brazilian community: the Bambui Health Ageing Study. doi
  43. (2005). Prognosis of depression in old age compared to middle age: a systematic review of comparative studies. doi
  44. (2000). Psychometric properties of the schedules for the clinical assessment in neuropsychiatry(SCAN-2.1). Soc Psychiatr Epidemiol doi
  45. Review of the community prevalence of depression in later life. doi
  46. Sample size calculations for comparative studies of medical tests for detecting presence of disease. doi
  47. (1996). SCAN and the PSE tradition. Soc Psychiatry Psychiatr Epidemiol doi
  48. (1990). Schedules for Clinical Assessment in Neuropsychiatry(SCAN). Arch Gen Psychiatry
  49. (2003). Screening accuracy for late-life depression in primary care: a systematic review. J Fam Pract.
  50. (2005). Screening and case finding instruments for depression. Cochrane Database Syst Rev. doi
  51. (2002). Screening for depression across the Lifespan: A review of Measures for Use in Primary Care Settings. American Family Physician.
  52. Screening for Depression in Adults in Primary Care Settings: A systematic evidence review.
  53. (2002). Screening for depression in adults: a summary of the evidence for the U.S. preventative services task force. Ann Intern Med
  54. (2010). Screening for depression in elderly medical inpatients from rural area of Norway: prevalence and associated factors. doi
  55. (2006). Screening for depression in Older medical inpatients. doi
  56. (2003). Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ doi
  57. (1999). Short versions of the Geriatric Depression Scale: A study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. doi
  58. (2006). Should we screen for depression? BMJ doi
  59. (1982). Social origins of depression in old age. doi
  60. The association of depression and mortality in elderly persons: a case for multiple independent pathways. doi
  61. (1991). The changing patterns of referrals for psychogeriatric consultation in general hospital: an 8 year study. doi
  62. (2006). The criterion validity of the Geriatric Depression Scale: a systematic review. Acta Psychiatr Scand doi
  63. (1990). The effect of mild to moderate dementia on the Geriatric Depression Scale and on the General Health Questionnaire. Age Ageing doi
  64. (2001). The effectiveness of very short scales for depression screening in elderly medical patients. doi
  65. (2008). The epidemiology of psychiatric disorders in Quebec‟s older adult population.
  66. (2001). The expert consensus guideline series. Pharmacotherapy of depressive disorders in older patients. Postgrad Med
  67. (2000). The prevalence and differential diagnosis of subclinical depressive syndromes in inpatients 60 years and older. Psychother Psychosom. doi
  68. The prognosis of depression. doi
  69. (1989). The recognition, diagnosis, and treatment of mental disorders by primary care physicians. Med Care doi
  70. (1989). The role of electroconvulsive therapy in the treatment of depressive illness in old age. doi
  71. The validation of the Edinburgh Post-natal Depression Scale on a Community Sample. doi
  72. (2006). Treatments for later-life depression: a metaanalytic comparison of pharmacotherapy and psychotherapy. doi
  73. (2001). Understanding Clinical Papers. doi
  74. (1999). Using an annual over-75 health check to screen for depression: validation of the short Geriatric Depression Scale(GDS 15) within general practice. doi
  75. (2004). Validation of short screening tests for depression and cognitive impairment in older medically ill inpatients. doi
  76. (1996). Validation of the Edinburgh postnatal scale in non-postnatal women. doi
  77. (2003). Validation of the Five-Item Geriatric Depression Scale in Elderly in Three Different Settings. doi
  78. (2001). World Health Organisation (WHO) report on mental illness released

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.