Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0046
Trends in Psychiatry and Psychotherapy
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Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study

Acurácia da versão de 15 itens da Escala de Depressão Geriátrica (GDS-15) em uma amostra de idosos muito-idosos residentes na comunidade: Estudo Pietà

Filipi Leles da Costa Dias; Antônio Lúcio Teixeira; Henrique Cerqueira Guimarães; Maira Tonidandel Barbosa; Elisa de Paula França Resende; Rogério Gomes Beato; Karoline Carvalho Carmona; Paulo Caramelli

http://dx.doi.org/10.1590/2237-6089-2017-0046 Trends Psychiatry Psychother, vol.39, n4, p.276-279, 2017
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Abstract

Abstract Introduction Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. Objectives To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. Methods We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Results Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). Conclusion GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.

Keywords

Depression, geriatric psychiatry, geriatric assessment

Resumo

Resumo Introdução A depressão geriátrica (DG) é um transtorno prevalente que permanece sendo subdiagnosticado. Ferramentas validadas para rastreio de DG em idosos muito idosos na prática clínica são necessárias, especialmente em países em desenvolvimento. Objetivos Avaliar a acurácia diagnóstica da Escala de Depressão Geriátrica (Geriatric Depression Scale, GDS-15) em uma população de idosos muito idosos residentes na comunidade. Métodos Foram avaliados, com a GDS-15, 457 indivíduos nãodemenciados, residentes na comunidade, com idade ≥75 anos. O diagnóstico definitivo de depressão maior foi realizado através da entrevista semiestruturada Mini International Neuropsychiatric Interview (MINI), de acordo com os critérios do DSM-IV. Resultados Cinquenta e dois indivíduos (11,4%) foram diagnosticados com episódio depressivo maior. A área sob a curva receiver operating characteristic (ROC) foi de 0,908 (p<0,001). Utilizando-se o ponto de corte 5/6 (não-deprimido/deprimido), 84 (18,4%) indivíduos foram considerados deprimidos pela GDS-15 (coeficiente de kappa = 53,8%, p<0,001). O ponto de corte 4/5 atingiu a melhor combinação entre sensibilidade (86,5%) e especificidade (82,7%) (índice de Youden = 0,692), com valor preditivo negativo robusto (0,9802) e razoável valor preditivo positivo (0,3819). Conclusão A GDS-15 demonstrou boa acurácia para o rastreio de depressão maior nesta amostra de base populacional de idosos muito idosos com baixa escolaridade. Os resultados do presente estudo indicam que o ponto de corte 4/5 mostrou-se mais adequado para utilização nesta população.

Palavras-chave

Depressão, psiquiatria geriátrica, avaliação geriátrica

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