Validation of a brief screening tool to detect depression in elderly ED patients

Although depression is the most common psychiatric disorder in the elderly, it is often unrecognized by physicians. The objective of the study was to assess the utility of a 3-question screening instrument (ED-DSI) to detect depression among elderly emergency department (ED) patients. We used a pros...

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Bibliographic Details
Published in:The American journal of emergency medicine 2002-03, Vol.20 (2), p.99-102
Main Authors: Fabacher, Diana A., Raccio-Robak, Nancy, McErlean, Mara A., Milano, Peter M., Verdile, Vincent P.
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Aged
Aged, 80 and over
Biological and medical sciences
Depression
Depression - diagnosis
elderly
emergency department
Emergency Service, Hospital
Female
Geriatric Assessment
Health Status Indicators
Humans
Male
Mass Screening - methods
Medical History Taking
Medical sciences
Mood disorders
Prospective Studies
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
screening tool
Sensitivity and Specificity
Surveys and Questionnaires
validation
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Summary:Although depression is the most common psychiatric disorder in the elderly, it is often unrecognized by physicians. The objective of the study was to assess the utility of a 3-question screening instrument (ED-DSI) to detect depression among elderly emergency department (ED) patients. We used a prospective convenience sample of English-speaking ED patients ≥65yr. Patients were excluded for being too ill to participate, having obvious dementia, or acute changes in mentation. A physician administered the ED-DSI. Trained research personnel blinded to ED-DSI answers then administered the 30 question Geriatric Depression Scale (GDS). The ED-DSI was considered positive if the patient answered yes to one or more questions and subjects were considered depressed when the GDS score was ≥10. ED-DSI was compared to GDS using contingency tables. A total of 103 subjects were enrolled. Average age was 75 years and subjects were predominately female (66%) and white (85%). GDS identified 33 patients (32%) as depressed. Of these, 26 were correctly identified by ED-DSI giving an ED-DSI sensitivity of 79% (95%CI (65%, 93%)) specificity of 66% (95%CI (54%, 78%)) and a negative predictive value of 87% (95%CI (79%, 95%)). The 3-question ED-DSI is a useful tool to detect depression in this population of ED patients. (Am J Emerg Med 2002;20:99-102. Copyright 2002, Elsevier Science (USA). All rights reserved.)
ISSN:0735-6757
1532-8171
DOI:10.1053/ajem.2002.30103