Larraga Laura, Saz Pedro, Dewey Michael E, Marcos Guillermo, Lobo Antonio
Universidad de Zaragoza and Hospital Clínico Universitario, Zaragoza, Spain.
Int J Geriatr Psychiatry. 2006 Dec;21(12):1199-205. doi: 10.1002/gps.1642.
To standardize the EURO-D scale as a method for detecting depression in Spanish older people.
In a first phase, a sample of 1080 community older people was assessed with the GMS-AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non-cases were assessed using DSM-III-R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test-retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated.
A high internal consistency was obtained in both phases of the study (alpha = 0.75; alpha = 0.79, respectively). Test-retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM-III-R diagnosis validity coefficients (cut-off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89-0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale.
The EURO-D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results.
将EURO - D量表标准化，作为检测西班牙老年人抑郁症的一种方法。
在第一阶段，由非专业访谈员使用GMS - AGECAT对1080名社区老年人样本进行评估。在第二阶段，由精神科医生使用DSM - III - R诊断法对所有可能的病例以及数量相近的随机抽取的可能非病例进行评估。为测试信度，计算了Cronbachα系数的内部一致性以及重测信度（Kappa值）。计算了效度、敏感度和特异度、预测值、受试者工作特征（ROC）曲线以及似然比（SSLR）。
研究的两个阶段均获得了较高的内部一致性（α分别为0.75和0.79）。重测信度可以接受（加权kappa = 0.60）。对于DSM - III - R诊断预测，效度系数（截断点3/4）为：敏感度91.8%，特异度76.6%，ROC曲线下面积0.92 [95%置信区间（0.89 - 0.95）]。文盲和认知困难对该量表的性能有较小的负面影响。
EURO - D量表是检测西班牙老年人可能患抑郁症情况的一种可靠且有效的工具。在解释结果时应考虑文盲和认知困难因素。
