Magazine article Clinical Psychiatry News

Questionnaire Tops Other Mood Evaluations

Magazine article Clinical Psychiatry News

Questionnaire Tops Other Mood Evaluations

Article excerpt

WASHINGTON -- A nine-item questionnaire of self-reported symptoms was more reliable and efficient than the widely used Geriatric Depression Scale and the Minimum Data Set 2.0 scale at assessing mood disorders in nursing home patients, according to a study in 71 facilities across eight states.

Accurate detection of mood disorders in the long-term care population remains a constant challenge, said Dr. Debra Saliba, who is a geriatrician at the University of California, Los Angeles, and the director of the Borun Center for Gerontological Research there. She reported the results at the annual meeting of the American Geriatrics Society.

Identifying depression in nursing home patients is important, she emphasized, because the condition is associated with poor functional status; increased perception of pain; stress; suicide; and increased need for medical services. "In fact, a disproportionate number of successful suicides occur in people over the age of 65," said Dr. Saliba.

Treating depression can be effective in reducing poor outcomes in long-term care residents, but depression often goes unnoticed in this population. There are several screening tools for mood disorders in use, but they have not been compared with one another or to any validated psychiatric-assessment tool, Dr. Saliba explained.

The new study compared the effectiveness of the nine-item Patient Health Questionnaire (PHQ-9), the Geriatric Depression Scale (GDS), Minimum Data Set version 2.0 (MDS 2.0) assessment by staff, and one of two validated tools for identifying mood disorders in a long-term care population.

The GDS was designed for older adults and has become a geriatric standard--this study used the newer version of the test, which is made up of 15 yes/no questions--but other studies have suggested that the test may be overly influenced by somatic symptoms when individuals answer questions such as, "Have you stopped many of your activities and interests?" without being able to elaborate.

By contrast, PHQ-9 questions prompt open-ended responses to topics including sleep problems, feeling bad about oneself, and having trouble concentrating. The tool may be administered either as a self-reported survey or as part of an interview. The MDS 2.0 observer-rated scale avoids an interview or self-report. …

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