PatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.
This is suitable as a screening test for depressive symptoms in the elderly; ideal for evaluating the clinical severity of depression, and therefore for monitoring treatment. It is easy to administer, needs no prior psychiatric knowledge and has been well validated in many environments.
The original GDS was a 30 item questionnaire - time consuming and challenging for some patients (and staff). Later versions retain only the most discriminating questions; their validity approaches that of the original form.
Depression assessments such as the 4 item Geriatric Depression Scale are easy and quick to perform with a high sensitivity and specificity. Patients who screen positive for depression should be considered for antidepressants and be reassessed cognitively when their depression has lifted. Care must be taken as dementia and depression often co-exist.
Dr Yesavage has confirmed that the original scale (from which the calculator has been derived) is in the public domain due to it being partly the result of US Federal support.
The fifteen item (GDS-15) and 4 item (GDS-4) versions of the geriatric depression scale are good methods of screening for major depression (as is the 10 item version). The shorter of these (GDS-4) is of limited clinical value in monitoring the severity of the depressive episode (may be better used to exclude depression). The systematic use of short GDS versions in Primary Care may increase detection rates of depression among the elderly.
Further reading & references
- Brink TL, Yesavage JA, Lum O, Heersema P, Adey MB, Rose TL: Screening tests for geriatric depression. Clinical Gerontologist 1: 37-44, 1982.
- Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey MB, Leirer VO: Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research 17: 37-49, 1983.
- Sheikh JI, Yesavage JA: Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontology : A Guide to Assessment and Intervention 165-173, NY: The Haworth Press, 1986.
- van Marwijk HW, Wallace P, de Bock GH, et al; Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. Br J Gen Pract. 1995 Apr;45(393):195-9.
- Almeida OP, Almeida SA; 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. Int J Geriatr Psychiatry. 1999 Oct;14(10):858-65.
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Dr Huw Thomas
Dr Huw Thomas