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Do you think you suffer from depression? Reevaluating the use of a single item question for the screening of depression in older primary care patients
- Authors:
- AYALON Liat, GOLDFRACHT Margalit, BECH Per
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(5), May 2010, pp.497-502.
- Publisher:
- Wiley
The majority of older adults prefer to receive their mental health treatment in primary care. However, despite efforts to integrate depression treatment into primary care, depression often remains undetected. There is therefore a need to identify appropriate screening tools for depression. The goal of this study was to compare a single item screening for depression to 3 existing depression screening tools. The participants were a cross sectional sample of 153 older primary care patients in 2 clinics in Israel who completed the following depression-screening measures: a single depression screen, Patient Health Questionnaire-9, Major Depression Inventory, Visual Analogue Scale. The measures were evaluated against a depression diagnosis made by the Structured Clinical Interview for DSM-IV. The results showed that overall 3.9% of the sample was diagnosed with depression. The most notable finding was that the single-item question, ‘Do you think you suffer from depression?’ had as good or better sensitivity (83%) than all the other screens. Nonetheless, its specificity of 83% suggested that it has to be followed up by a thorough diagnostic interview. Additional sensitivity analyses concerning the use of a single depression item taken directly from the depression screening measures supported this finding.
The perspectives of older care recipients, their family members, and their round-the-clock foreign home care workers regarding elder mistreatment
- Author:
- AYALON Liat
- Journal article citation:
- Aging and Mental Health, 14(4), May 2010, pp.411-415.
- Publisher:
- Taylor and Francis
Older adults with neuropsychiatric symptoms in dementia are more likely to experience abuse and neglect. One of the most popular long-term care alternatives is round-the-clock care by foreign home care workers. The goal of this study was to identify attitudes towards the management of neuropsychiatric symptoms in Alzheimer’s disease and to evaluate perspectives as to what constitutes elder mistreatment from the perspective of 3 stakeholders: older care recipients; their foreign home care workers; and their family members. Since the foreign home care workers come from different cultural backgrounds, it was hypothesised that their attitudes would deviate from the other stakeholders. Overall, 88 older care recipients, 142 family members, and 127 foreign home care workers responded to a hypothetical case vignette querying about the appropriate care of an older woman who suffers from neuropsychiatric symptoms in dementia. The results showed that foreign home care workers tended to be more lenient toward elder mistreatment relative to older adults and their family members and to view as effective techniques that would non-equivocally be considered abusive and ineffective by current standards. The article concludes that interventions should inform these stakeholders about what constitutes elder mistreatment and should be particularly geared toward addressing cultural differences in the perception of elder mistreatment.