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Family Practice Vol. 20, No. 6, 682-684
© Oxford University Press 2003, all rights reserved

Article

Performance of a single screening question for depression in a representative sample of 13 670 people aged 75 and over in the UK: results from the MRC trial of assessment and management of older people in the community

David PJ Osborn, Astrid E Fletchera, Liam Smeetha, Susan Stirlinga, Christopher J Bulpittb, Maria Nunesb, Elizabeth Breezea, Edmond SW Nga, Dee Jonesc and Alistair Tullochd

Department of Epidemiology, and a Centre for Ageing and Public Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, b Section of Care of the Elderly, Imperial College, Faculty of Medicine, Hammersmith Campus, Du Cane Road, London W12 ONN, c University Department of Geriatric Medicine, University of Wales College of Medicine, Cardiff CF64 2XX and d Unit of Health Care Epidemiology, University of Oxford, Oxford OX3 7LF, UK

Correspondence to Dr DPJ Osborn, Department of Psychiatry and Behavioural Sciences, Royal Free Campus, Royal Free and University College Medical School, Rowland Hill St, London NW3 2PF, UK; E-mail: dosborn{at}rfc.ucl.ac.uk

Background. A concise, accurate screening question for depression would be an important contribution to the Single Assessment Process for Older People.

Objective. To examine the performance of a previously validated screening question for depression, in a large community sample.

Methods. Both the single screening question, and the Geriatric Depression Scale (GDS-15) were completed by 13 670 people aged 75 and over in the community. Responses to the question were compared with a ‘standard’ of scoring above different thresholds on the Geriatric Depression Scale (GDS-15).

Results. For more severe GDS-15 depression, the best performance of the question was a sensitivity of only 52% and a specificity of 93%.

Conclusion. Even at its best, the question therefore misses almost half the cases. This highlights the problems of such simple approaches to routine screening.

Keywords. Depressive disorder diagnosis, mass screening, psychiatric status rating scales, sensitivity and specificity.


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