Kurlowicz Lenore H, Outlaw Freida H, Ratcliffe Sarah J, Evans Lois K
School of Nursing, University of Pennsylvania, Philadelphia, PA 19104-6096, USA.
Arch Psychiatr Nurs. 2005 Feb;19(1):3-9. doi: 10.1016/j.apnu.2004.11.001.
Variation in the presentation of depressive illness among older African Americans may complicate assessment of depression, especially among those with multiple medical comorbidities and functional disabilities. The purpose of this study was to explore the prevalence of depression among older poor African Americans attending an academic outpatient rehabilitation program, using a depression measure with low somatic item content. Correlates of depression in this population also were explored. Health-care records of 150 older African Americans seen over a 2-year period were examined. Depression was assessed on admission using the 30-item Geriatric Depression Scale (GDS). Using a GDS cutoff score for depression of 11 or higher, 30% of the sample (age 75.5 +/- 7.16 years, range 65-95, 75% women) scored positive for depression. Nine percent also reported having suicidal thoughts within the previous week. Consistent with existing literature, depressed patients, as compared to nondepressed patients, were significantly younger, more suicidal, more likely to rate their general health as poor, had higher mean ratings of pain, and more often limited their social activities. Six GDS items were found to have little ability to discriminate between depressed and nondepressed patients: satisfaction with life, getting bored easily, prefer staying at home, find life exciting, getting started on new projects, and full of energy. The authors recommend further testing of the GDS with similar populations of older, poor, medically ill, and functionally disabled older adults.
老年非裔美国人抑郁症表现的差异可能会使抑郁症的评估变得复杂，尤其是在那些患有多种合并症和功能残疾的人群中。本研究的目的是使用躯体项目内容较少的抑郁量表，探讨参加学术门诊康复项目的贫困老年非裔美国人中抑郁症的患病率。还探讨了该人群中抑郁症的相关因素。对在两年期间就诊的150名老年非裔美国人的医疗记录进行了检查。入院时使用30项老年抑郁量表（GDS）评估抑郁情况。使用GDS抑郁临界值11分及以上，30%的样本（年龄75.5±7.16岁，范围65 - 95岁，75%为女性）抑郁评分呈阳性。9%的人还报告在前一周内有自杀念头。与现有文献一致，与非抑郁患者相比，抑郁患者明显更年轻、更有自杀倾向、更有可能将自己的总体健康状况评为差、疼痛平均评分更高，并且更经常限制社交活动。发现GDS的六个项目在区分抑郁和非抑郁患者方面能力有限：对生活的满意度、容易感到无聊、更喜欢呆在家里、觉得生活令人兴奋、开始新项目以及精力充沛。作者建议在类似的老年、贫困、患有疾病且功能残疾的老年人群中进一步测试GDS。
