Validating a single-question depression measure among older adults. (20th September 2017)

• Record Type: Journal Article
• Authors: Min, Kyung-Duk; Chun, Heeran; Kim, Il-Ho; Cho, Sung-il
• Is Part Of: International psychogeriatrics. Volume 30:Number 1(2018)
• Page Start: 69
• Page End: 76
• Publication Date: 2017-09-20
• Subjects: depression measure, -- single question, -- composite index, -- accuracy; Geriatric psychiatry -- Periodicals; 618.9768905
• DOI: 10.1017/S1041610217001673
• Languages: English
• ISSNs: 1041-6102

Abstract

ABSTRACT: Background: A single-item depression measure may not be adequate in capturing the complex entity of mental health, despite wide use of this indicator in community studies. This study evaluated the accuracy of a single-question depression measure in comparison to two composite indices–the Center for Epidemiologic Studies Depression Scale (CESD) and the Geriatric Depression Scale (GDS). Materials and methods: A total of 800 elderly participants ranging from 60 to 89 years of age and residing in Seoul were recruited using a multistage sampling scheme in 2015. The survey was conducted by trained interviewers with a constructed questionnaire. Reliability and validity measures such as the Kappa index, sensitivity, specificity, PPV, NPV, and AUC were used to evaluate the accuracy of the single question measure. Socio-demographic group differences in accuracy were compared by age, sex, marital status, education, employment, and financial status. Results: The prevalence of depression by a single-question measure was much lower than those of CESD and GDS (5.5%, 12.3%, and 12.1%, respectively). The sensitivity of the single-item measure, based on CESD and GDS, was extremely low at 30.6% and 36.1%. In the subgroup analysis, however, there was a marked educational discrepancy in all accuracy measures; in sensitivity, people with a university degree or higher showed about 2.4 times higher sensitivity than those having only a primary school education. Conclusions: The results show that a single-question depression measure should be used with caution. In addition, the single-question measure could substantially underestimate depression among the risk group of older adults.