Department of Psychological Medicine, Monash University, Melbourne, Australia.
J Affect Disord. 2010 Sep;125(1-3):361-4. doi: 10.1016/j.jad.2010.01.008.
Psychiatric surveys based on the Composite International Diagnostic Interview (CIDI) report very low rates of affective disorder in older people, perhaps because CIDI's long, convoluted screening questions present a special challenge to aged respondents. We have shown previously that inconsistencies in responses to CIDI's two screening questions about dysphoria and anhedonia rose in frequency with age. By contrast, responses to the short, simple K-10 and GHQ-12 mental health scales showed much less change over the lifespan. As a check on age-related bias, we now compare responses to CIDI's depression screening questions with responses to subsequent, simpler questions about other depressive symptoms.
Secondary analysis of an Australian national survey in which CIDI was administered to 10,641 adults by trained lay interviewers.
Rates of positive responses to both CIDI screening questions fell from 11% in age-group 18-34 years to 3% in respondents aged > or = 65 years. Responses to simpler CIDI items about other depressive symptoms and help-seeking behaviour showed much less change with age.
Older respondents may deny symptoms when subjected to complex batteries of questions concerning severity, time frame, attribution and consequences. CIDI diagnoses need to be validated across the full age spectrum.
Residents of aged care facilities and those with low cognitive scores were excluded.
基于复合国际诊断访谈（CIDI）的精神科调查报告显示，老年人中情感障碍的发病率非常低，这可能是因为 CIDI 冗长而复杂的筛选问题对老年受访者构成了特殊挑战。我们之前已经表明，对 CIDI 关于抑郁和快感缺失的两个筛选问题的回答不一致性随着年龄的增长而增加。相比之下，对简短、简单的 K-10 和 GHQ-12 心理健康量表的反应在整个生命周期中变化不大。作为对与年龄相关的偏见的检查，我们现在将 CIDI 的抑郁筛选问题的反应与随后关于其他抑郁症状的更简单问题的反应进行比较。
对澳大利亚全国性调查的二次分析，其中由经过培训的非专业访谈员通过 CIDI 对 10641 名成年人进行了调查。
对 CIDI 两个筛选问题的阳性反应率从 18-34 岁年龄组的 11%下降到≥65 岁年龄组的 3%。对 CIDI 关于其他抑郁症状和寻求帮助行为的更简单项目的反应随着年龄的增长变化较小。
当面对涉及严重程度、时间框架、归因和后果的复杂问题时，老年受访者可能会否认症状。CIDI 诊断需要在整个年龄范围内进行验证。
排除了养老院居民和认知评分较低者。
