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Beside the Geriatric Depression Scale: the WHO-Five Well-being Index as a valid screening tool for depression in nursing homes
- Authors:
- ALLGAIER Antje-Kathrin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(11), 2013, pp.1197-1204.
- Publisher:
- Wiley
The aim of the study was to compare criterion validities of the WHO-Five Well-being Index (WHO-5) and the Geriatric Depression Scale 15-item version (GDS-15) and 4-item version (GDS-4) as screening instruments for depression in nursing home residents. Data from 92 residents aged 65–97 years without severe cognitive impairment (Mini Mental State Examination ≥15) were analysed. Criterion validities of the WHO-5, the GDS-15 and the GDS-4 were assessed against diagnoses of major and minor depression provided by the Structured Clinical Interview for DSM-IV. Subanalyses were performed for major and minor depression. Areas under the receiver operating curve (AUCs) as well as sensitivities and specificities at optimal cut-off points were computed. Prevalence of depressive disorder was 28.3%. The AUC value of the WHO-5 (0.90) was similar to that of the GDS-15 (0.82). Sensitivity of the WHO-5 at its optimal cut-off of ≤12 was significantly higher than that of the GDS-15 at its optimal cut-off of ≥7. The WHO-5 was equally sensitive for the subgroups of major and minor depression, whereas the GDS-15 was sensitive only for major depression, but not for minor depression. For specificity, there was no significant difference between WHO-5 and GDS-15, but both instruments outperformed the GDS-4. The WHO-5 demonstrated high sensitivity for major and minor depression. Being shorter than the GDS-15 and superior to the GDS-4, the WHO-5 is a promising screening tool that could help physicians improve low recognition rates of depression in nursing home residents. (Edited publisher abstract)