Pocklington Claire, Gilbody Simon, Manea Laura, McMillan Dean
Hull York Medical School, Heslington, York, UK.
Hull York Medical School and Department of Health Sciences, University of York, Heslington, York, UK.
Int J Geriatr Psychiatry. 2016 Aug;31(8):837-57. doi: 10.1002/gps.4407. Epub 2016 Feb 18.
Depression in older adults is often under recognised despite it being the most common mental health illness in this age group. An increasing older adult population highlights the need for improved diagnostic rates. Brief versions (15 items or less) of the Geriatric Depression Scale (GDS), which are suitable for busy clinical practice, could improve detection rates.
Our aim is to establish the diagnostic accuracy of brief versions of the GDS.
Twelve electronic databases of published and unpublished literature were searched. Study selection was in accordance with predefined inclusion and exclusion criteria. A recognised gold-standard diagnostic instrument was used as a comparator against data pertaining to the use of a brief version of the GDS in an older adult population. The QUADAS-II was utilised for quality assessment. Narrative analysis and, where possible, meta-analysis were performed.
Thirty-two studies were identified that provided diagnostic data regarding seven brief versions of the GDS (1, 4, 5, 7 8, 10 and 15-item versions). Pooled sensitivity was 0.89 (95% confidence interval (CI) 0.80-0.94), and specificity was 0.77 (95% CI 0.65-0.86) for the GDS-15 at the recommended cut-off score of 5. Meta-analysis of other brief versions was not possible because of an insufficient number of studies with standardised items.
Results suggest the possibility of selective reporting of cut-off scores, and therefore, findings should be approached cautiously. Studies should report all cut-off scores, and all brief GDS versions should be compiled of standardised items. Copyright © 2016 John Wiley & Sons, Ltd.
尽管抑郁症是老年人群中最常见的心理健康疾病，但在老年人中往往未得到充分认识。老年人口的不断增加凸显了提高诊断率的必要性。适用于繁忙临床实践的简短版（15项及以下）老年抑郁量表（GDS）可能会提高检出率。
我们的目的是确定简短版GDS的诊断准确性。
检索了12个已发表和未发表文献的电子数据库。研究选择符合预定义的纳入和排除标准。使用公认的金标准诊断工具作为对照，对比老年人群中使用简短版GDS的数据。采用QUADAS-II进行质量评估。进行叙述性分析，并在可能的情况下进行荟萃分析。
共确定了32项研究，这些研究提供了关于GDS七个简短版本（1项、4项、5项、7项、8项、10项和15项版本）的诊断数据。在推荐的临界值分数为5时，GDS-15的合并敏感性为0.89（95%置信区间（CI）0.80 - 0.94），特异性为0.77（95%CI 0.65 - 0.86）。由于标准化项目的研究数量不足，无法对其他简短版本进行荟萃分析。
结果表明存在选择性报告临界值分数的可能性，因此，对研究结果应谨慎对待。研究应报告所有临界值分数，并且所有简短版GDS都应由标准化项目组成。版权所有© 2016约翰威立父子有限公司。
