Effect of instructional set on responses to the Geriatric Depression Scale.

A community sample of elderly subjects (M age?=?74 years) was randomly assigned to four variations in reference group instructions on the Geriatric Depression Scale (GDS). In one condition, subjects received no instructions as to reference group, which is the standard instructional format of the test. In the other three conditions, subjects were asked to compare themselves with one of three reference groups: age group peers, adults in general, or themselves at a younger age. Results indicated that the GDS is robust with respect to variation in reference group instruction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression in Parkinson's disease: clinical correlates and outcome

Depression has been shown to be more common in Parkinson's disease (PD) than in other chronic and disabling disorders. Neurochemical and functional disturbances are important etiopathogenic factors. The prevalence and clinical features associated with depression in PD remain controversial. The purpose of this study is to estimate the prevalence of depressive symptoms in our patients, as related to other clinical data, and to assess clinical outcomes of these symptoms. A series of PD patients were evaluated over a 9-year period, using the Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr stage (HY), Schwab and England Scale (SE), Mini-Mental State Examination (MMSE), and Yesavage Geriatric Depression Scale (GDS). Presence of depressive symptoms was considered if GDS score was higher than 10: mild-moderate (MD) for GDS scores between 11 and 20 and moderate-severe (SD) for GDS scores greater than 20. Three hundred and fifty-three patients were included in this study and additional follow up information was obtained for 184 patients. MD and SD were found in 40.2 and 16.7% of PD patients, respectively. Female gender, high HY, high UPDRS total and subtotal, and low MMSE and SE scores were significantly associated with depressive symptoms. According to changes in GDS score, 34% of patients remained stable, 35% showed an improvement, and 30.9% worsened in the follow up study. Gender, age, age of onset, HY, UPDRS, and PD duration are not related to depression outcome.     

Determinants of functional status in healthy Italian nonagenarians and centenarians: a comprehensive functional assessment by the instruments of geriatric practice

OBJECTIVE: To evaluate the physical ability and psychocognitive status of a population more than 90 years of age with regard to sociodemographic, behavioral, and biomedical variables known to affect functional status in old age. DESIGN: A survey design was used. SETTING: Emilia Romagna, Northern Italy. PARTICIPANTS: Eighty-four healthy community-dwelling subjects aged 90 to 106 years. MEASUREMENTS: Sociodemographic variables, health behavior, anthropometric indices, and serum DHEAS levels were recorded. Functional assessment was performed by instruments currently used in geriatric practice: the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Activities of Daily Living (ADL) scale. A stepwise multiple regression analysis was performed. RESULTS: GDS scores correlated directly with MMSE scores and inversely with ADL severity scores. Poor education, institutionalization, sensory impairment, muscular mass loss, and lower DHEAS levels were the variables with the highest correlation to functional impairment. Smoking, alcohol consumption, and marital status were relatively unimportant. An inverse association was found between DHEAS levels and dependency scores of single ADLs (continence, mobility). CONCLUSION: Impaired cognitive and physical ability with no increase in depression prevalence was found in a sample of subjects more than 90 years of age free of major age-related disease. Muscular mass and DHEAS levels seem to play a role in maintaining physical independence. In turn, physical independence, as well as social and cultural factors, strongly affect the compliance of long-lived subjects with psychocognitive tests currently used in the clinical evaluation of younger old people, suggesting that these instruments are not reliable for screening for cognitive impairment and depression in the oldest old subjects.     

Neuropsychological impairment, depression, and Parkinson's disease.

Examined the nature of cognitive impairment in Parkinson's disease (PD) and its relation to depression in 89 nondemented (mean age 69.35 yrs) and 19 demented (mean age 79.94 yrs) PD patients and 64 control Ss (mean age 66.44 yrs). PD Ss were significantly more depressed than controls on the Beck Depression Inventory and the Geriatric Depression Scale (GDS). There were significant, negative associations between scores on the GDS and performance on 8 neuropsychological test variables. Both PD groups were significantly impaired on 7 neuropsychologial test variables, including measures of visuomotor, memory, and executive functions. The demented PD group was more impaired than the nondemented PD and control groups on 9 neuropsychological test variables. Cognitive impairments in the nondemented PD group were relatively subtle and not apparent on the Mini-Mental State Examination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generalizability of a checklist for assessment of psychopathy.

Suggests that there are problems associated with assessments of psychopathy in prison populations that use self-report inventories and global diagnostic procedures. In response to these problems, the authors developed a behavioral checklist for psychopathy. The psychometric qualities of the checklist were evaluated using generalizability theory and classical test score indices of reliability. In each of 5 yrs, 2 raters (usually different each year) rated prison inmates (N?=?301; mean age 26.9 yrs) on 22 items. The generalizability coefficients were .85, .86, and .89 for the years 1977–1981, respectively. The generalizability coefficient for a test–retest study was .89. Classical indices of reliability (alpha coefficients and inter- and intrarater reliability) ranged from .82 to .93. Results indicate that the checklist is a highly reliable and generalizable instrument when used with prison populations. It is highly correlated with global ratings of psychopathy and criteria from the DSM-III for antisocial personality disorder. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of depression among long-term insulin-dependent diabetics.

Examined the degree to which demographic characteristics, marital and family relationships, knowledge and management of disease, number and severity of complications, self-esteem, locus of control, and life satisfaction were related to depression among 57 long-term insulin-dependent diabetics (mean age 43.5 yrs). Ss were administered the Beck Depression Inventory, an interview schedule, a complications checklist, the Coopersmith Self-esteem Inventory, Rotter's Internal–External Locus of Control Scale, and the Life Satisfaction Index. Depression was found to be related to age and number of children, marital relationship variables, management of diet, coping with complications, and self-esteem. All but 1 of the Ss were suffering from at least 1 of the serious complications of diabetes. The number of complications and severity of complications were significantly related to degree of depression, but both number and severity failed to contribute significantly to depression in multiple-regression analysis. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The many faces of depression following spousal bereavement

While it is becoming increasingly clear that mood disorders tend to be chronic, intermittent and/or recurrent conditions with different manifestations over time, little is known of the variability or course of mood disorders that are associated with severe psychosocial stress. This paper reports on the prevalence and course of major, minor, and subsyndromal depressions in 328 widows and widowers followed prospectively from 2 to 25 months following one of the most disruptive of all naturally occurring stressors, spousal bereavement. The results are consistent with the following conclusions: (1) past major depression (prior to the death) predicts an increased risk for major depression following bereavement; (2) membership in any of the unipolar subgroups, in turn, predicts future depression throughout the unipolar depressive spectrum; (3) subsyndromal and minor depression stand between major depression, on the one hand, and no depression, on the other, in terms of their effects on overall adjustment to widowhood. Thus, the results support the validity of subsyndromal depression, and that the three subgroups (major, minor and subsyndromal depression) are pleiomorphic manifestations of the same unipolar depression disorder.     

Depression in university students: Duration, relation to calendar time, prevalence, and demographic correlates.

The duration, relation to calendar time, prevalence, and demographic correlates of depression in university students were studied by administering the Beck Depression Inventory to 4 independent samples (N?=?222) either once or twice at 3 points in time separated by 3-wk intervals. The 3-wk test–retest reliability was .78. There was no significant effect of the 3 points in time sampled. 17% of the Ss scored depressed; of these, 67% still scored depressed 3 wks later. Depression was significantly negatively correlated with year level but was not significantly associated with sex, marital status, their interaction, or age. There was no difference between the rates of depression in lowerclassmen in 1974 and 1977. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression.

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response styles among patients with minor depression and dysthymia in primary care.

Ruminative responses to depression have predicted duration and severity of depressive symptoms. The authors examined how response styles change over the course of treatment for depression and as a function of type of treatment. They also examined the ability of response styles to predict treatment outcome and status at follow-up. Primary care patients (n=96) with dysthymia or minor depression were randomly assigned to problem-solving therapy, paroxetine, or placebo. Patients' depressive symptoms and rumination, but not distraction, decreased over time. Pretreatment rumination and distraction were associated with more depressive symptoms at the conclusion of treatment; the latter finding was not consistent with the response style theory of depression. Results are discussed in terms of their implications for this theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

BACKGROUND: Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence of depression in different patient groups has been questioned. METHODS: Psychometric properties of the HADS were assessed in six different groups of Dutch subjects (N = 6165): (1) a random sample of younger adults (age 18-65 years) (N = 199); (2) a random sample of elderly subjects of 57 to 65 years of age (N = 1901); (3) a random sample of elderly subjects of 66 years or older (N = 3293); (4) a sample of consecutive general practice patients (N = 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms (N = 169); and (6) a sample of consecutive psychiatric out-patients (N = 491). RESULTS: Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test-retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. CONCLUSIONS: The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a 'case-identifier' for psychiatric disorder or depression.     

Screening instruments for depression and anxiety following stroke: experience in the Perth community stroke study

Evaluation of the relative efficacy of three screening instruments for depression and anxiety in a group of stroke patients was undertaken as part of the Perth community stroke study. Data are presented on the sensitivity and specificity of the Hospital Anxiety and Depression Scale (HAPS), the Geriatric Depression Scale and the General Health Questionnaire (GHQ) (28-item version) in screening patients 4 months after stroke for depressive and anxiety disorders diagnosed according to DSM-III criteria. The GHQ-28 and GDS but not the HADS depression, were shown to be satisfactory screening instruments for depression, with the GHQ-28 having an overall superiority. The performance of all 3 scales for screening post-stroke anxiety disorders was less satisfactory. The HADS anxiety had the best level of sensitivity, but the specificity and positive predictive values were low and the misclassification rate high.     

Model stability of the 15-item Geriatric Depression Scale across cognitive impairment and severe depression.

The 15-item Geriatric Depression Scale (GDS) is used in a wide variety of clinical and research settings. The study's purpose was to further establish the validity of the 15-item GDS by exploring the underlying factor structure in a healthy, nondemented sample of older adults and then analyzing whether this factor structure remained stable across a sample of demented individuals and a sample of individuals with a history of depression 6 months after discharge from an inpatient psychiatric setting. A 2-factor model fit the data best in the exploratory analyses. The 2 factors, Life Satisfaction and General Depressive Affect, found in the nondemented sample (r = .39) remained stable across cognitive impairment (r = .12) but merged into a 1-factor model in the psychiatric sample (r = .93). The results indicate that nondepressed older adults with poor life satisfaction may be identified as depressed on screening instruments such as the 15-item GDS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Geriatric Depression Scale and the Beck Depression Inventory as screening instruments in an older adult outpatient population.

Compared older adult outpatients with major depression (n?=?25) and healthy control Ss (n?=?25) using the Geriatric Depression Scale (GDS) and the Beck Depression Inventory (BDI). Both measures were sensitive in detecting clinical depression. Ss were, however, more likely to endorse multiple response on BDI items, suggesting that the GDS is simpler for older adults to complete. Viewed within the context of previous relevant research that used these instruments to compare older adults, the results yield additional evidence of cross-study consistency in the functional efficiency of both measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia

Psychometric properties of the Beck Anxiety Inventory (BAI) (Beck and Steer, 1990) were investigated in a sample of 82 patients suffering from panic disorder with agoraphobia. Before and after brief treatment, patients completed a battery of questionnaires and, for 2-week periods, kept a daily panic diary in which they recorded panic attacks, fear of panic, and average anxiety. The BAI demonstrated excellent internal consistency and good test-retest reliability over a 5-week interval. A partial multitrait, multimethod correlation matrix provided evidence of convergent validity with other measures of anxiety and of divergent validity vis á vis measures of depression. Factor analyses of pretest scores and residual gain scores used to address criticism that the BAI is excessively panic-centric yielded mixed results. In one analysis, the BAI was loaded with multimethod measures of panic and anxiety and, in the other, with questionnaire methods of assessing anxiety and depression. However, the BAI was clearly distinguished from measures of fear of fear, a central construct in panic disorder, and agoraphobic avoidance. Finally, the BAI proved sensitive to change with treatment, yielding effect sizes for improvement comparable to those of other anxiety measures.     

Topography of four classes of Kenyon cells in the mushroom bodies of the cockroach

The authors compared 218 black and 68 white nursing home patients with dementia for differences in the prevalence, recognition, and treatment of depression. There were no racial differences in depressive symptoms, but whites were significantly more likely to receive a diagnosis of "possible depression" and there were few racial differences in clinical, social, or demographic factors associated with depression. Depression was often unrecognized and undertreated in both racial groups; several depression instruments developed for use in dementia had good reliability and validity among blacks; and there were no significant differences in depressive symptoms or diagnosis between U.S.-born and Caribbean-born black patients. The absence of any appreciable interracial or intraracial differences in depression symptoms or diagnoses may reflect uniformity in nursing home selection criteria or lessening of mood differences that may have existed before admission.     

Antidepressant pharmacotherapy helps some cigarette smokers more than others.

Adult smokers (N?=?253) without clinically significant depression were randomized on a double-blind basis to receive fluoxetine (30 or 60 mg daily) or a placebo for 10 weeks in combination with cognitive-behavioral therapy (CBT). It was predicted that fluoxetine would selectively benefit smokers with higher baseline depression, nicotine dependence, and weight concern and lower self-efficacy about quitting smoking. Among those who completed the prescribed treatment regimen, baseline depression scores moderated the treatment response. Logistic regression analyses showed that 1 and 3 months after the quit date, fluoxetine increased the likelihood of abstinence, as compared with placebo, among smokers with minor depression but not among those with little or no depression. Results suggest that, as an adjunct to CBT, fluoxetine enhances cessation by selectively benefiting medication-compliant smokers who display even subclinical levels of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Minor depression in a cohort of young adults in Israel

BACKGROUND: A diagnosis of minor depression was considered for DSM-IV. Mild depression is thought to be common in primary care settings and the community, but studies of the validity of minor depression as a separate diagnostic category are few. METHODS: Minor depression as defined by Research Diagnostic Criteria was assessed by psychiatrists using a modified Schedule for Affective Disorders and Schizophrenia-Lifetime version in a cohort of 5200 young adults in Israel. Subjects with year-prevalent minor depression were compared with subjects with major depression or generalized anxiety disorder and with controls on aspects of psychopathologic condition, psychosocial functioning, help-seeking behaviors, and demographic correlates. RESULTS: Symptomatically, minor depression appeared to be a mild version of major depression. Minor depression was associated with good teenage and general social functioning, but also with absence from work, separation or divorce, recent impairment in overall functioning, and help-seeking. CONCLUSIONS: The results lend support for including minor depression or expanding severity modifiers in future classifications to better capture the phenomenon of subthreshold depression.     

Depressive symptoms and impaired respiration in sleep.

Documented the relationship between depression and impaired respiration in sleep among 176 males and 160 females (aged 50+ yrs) using the geriatric depression scale (GDS) developed by J. A. Yesavage et al (see record 1984-02939-001), which measures nonsomatic depressive symptoms. Although arbitrarily formed groups of Ss with low and high respiratory disturbance differed on the GDS, mean values and effect size suggested that impaired respiration in sleep was associated with only relatively mild depressive symptoms. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)