1. The center for epidemiological studies depression scale (CES-D) is an adequate screening instrument for depressive and anxiety disorders in a very old population living in residential homes.
- Author
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Dozeman, Els, van Schaik, Digna J. F., van Marwijk, Harm W. J., Stek, Max L., van der Horst, Henriette E., and Beekman, Aartjan T. F.
- Subjects
ANXIETY diagnosis ,DIAGNOSIS of mental depression ,COMPUTER software ,INTERVIEWING ,MEDICAL screening ,NURSING care facilities ,RESEARCH evaluation ,RESEARCH funding ,DATA analysis ,PREDICTIVE tests ,RECEIVER operating characteristic curves ,RESEARCH methodology evaluation - Abstract
Objective: The CES-D is an instrument that is commonly used to screen for depression in community based studies of the elderly, but the characteristics of the CES-D in a residential home population have not yet been studied. The aim of this study was to investigate the criterion validity and the predictive power of the CES-D for both depressive and anxiety disorders in a vulnerable, very old population living in residential homes. Methods: Two hundred seventy seven residents were screened with the CES-D, and subsequently interviewed with a diagnostic instrument, the Mini International Neuropsychiatric Instrument (MINI). The sensitivity, specificity, and positive and negative predictive value of the CES-D were calculated by cross-tabulation at different cut-off scores. Receiver Operating Characteristics (ROC) curves were used to assess the optimal cut-off point for each disorder and to asses the predictive power of the instrument. Results: In a residential home population the CES-D had satisfactory criterion validity for depressive disorders and for any combination of depressive and/or anxiety disorders. With a desired sensitivity of at least 80%, the optimal cut-off scores varied between 18 and 22. The predictive power of the CES-D in this population was best for major depression and dysthymia (Area Under the Curve, AUC 0.87), closely followed by the score for any combination of depressive and/or anxiety disorder (AUC 0.86). Conclusion: The use of one single instrument to screen for both depression and anxiety disorders at the same time has obvious advantages in this very old population. The CES-D seems to be a suitable instrument for this purpose. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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