A Preliminary Study on Standardization of Korean Form of Geriatric Depression Scale(KGDS) / 신경정신의학

The purpose of this study was to construct Korean Geriatric Depression Scale(KGDS) items and test the reliability and validity of KGDS. Total 151 items from GDS, BDI, SDS, MMPI-D, and K-CES-D were administered to 81 depressed elderly and 75 elderly control groups. Sixty-four preliminary items which have discrimination power between depression and control groups were selected. Then by correlational analysis considering adjusted item-total correlation, 40 items were finally chosen to construct KGDS. The values of Cronbach's alpha and split-half reliability were 0.88 and 0.79, respectively. The differences of means was signified at alpha=.001 level(patients group mean=23.40+/-8.13, control group mean=12.50+/-8.82, t=9.76). The result of factor analysis showed that KGDS had six factors. They were labeled negative thinking and unhappiness feeling(factor 1), emotional discomfort(factor 2), cognitive dysfunction(factor 3), decreased vitality(factor 4), physical weakening and inclosed somatic concern(factor 5), social withdrawal and loss of interest(factor 6), which represent depressive features of the elderly in thought, emotional, cognitive, physical, and social aspects. The total percentage of variance of the 6 factors was 51.2%. The result of discrimination analysis showed that hit ratio of KGDS was 76.7%, and the score of 16 was suggested as the optimal cut-off score. Additionally, by using percentile score distribution of control(normal) group, it is suggested that the score of 16-22 represents borderline or mild depression, the score of 23-25 are moderate depression, and greater than the score of 26 severe depression. Conclusively, KGDS not only improves diagnostic discrimination power 10% more than other depression scales including GDS, but also show sufficient reliability and validity, thus can be used for evaluaion of elderly depression. Finally, some issues relevant to sample selection and the necessity of concising content and items of KGDS are discussed.

A Study of Standardization of Korean Form of Geriatric Depression Scale(KGDS)

This study was aimed to standardize the Korean Geriatric Depression Scale (KGDS). In order to slove the unsatisfied discriminating power of Geriatric Depression Scale (GDS:Yesavage et al. 1983) presented in Korean studies, the authors made KGDs. The preliminary KGDS was costructed of 40 items selected from GDS, BDI, SDS, MMPI-D, CES-S and had satisfied reliability and validity, but had some problems in item contents, number of times, and sampling. Thus by correcting these problems, the authors made new KGDS of 30 item, and tested the reliability and validity of the final version of KGDS. The values of Cronbach's alpha and Split-half reliability were .88 and .79 respectively, and correlational coefficent with GDS was .87. The differences of means was signified at alpha=.001 level (patients group mean=17.82 (10.52), control group mean=10.52 (5.12), t=12.07). On factor anlaysis, 5 factors in KGDS were extracted. They were labeled Emotional discomfort (factor 1), Negative thinking and Unhappinesss feeling (factor 2), Physical weakening and decreased vitality (factor 3), Cognitive dysfunction (factor 4), Decreased social interest and activity (factor 5), which represent depressive features of the elderly in thought, emotional, cognitive, physical, social aspects. The total percentage of variance of 5 factors was 53.72%. The result of discriminatin anlaysis showed that hit ratio of KGDS was 75%, and the score of 14 was suggested as the optimal cut-off score. Additionally, by use percentile score distribution of control group (normal) subjects, each of the score of 14-18, 19-21, over 22 suggested borderline or mild depression, moderate depression, severe depression, respectively. Conclusively, the final version of KGDS not only improved diagnostic discriminatory power approxtimately 10% than GDS, but also showed satisfiable reliability and validity. So the KGDS could be a useful tool for evaluaion of elderly depression.

Depressive Symptoms in Elderly Patients with Physical Illness

OBJECTIVES: This study aimed to evaluate the effects of severity of functional disability, caused by physical illness, on the depressive symptoms and depressive disorders of the elderly patients (above 65 year-old) with physical illness. METHOD: Complete medical and psychiatric evaluations were achieved on 138 patients, except the 12 patients, who were severely cognitively impaired (MMSE-K score;below 19), of the 150 elderly patients (above 65 year-old) with physical illness. Sociodemographic data and health characteristic data were systematically collected, and the severity of functional disability caused by physical illness was evaluated. Depression scales (KGDS, GDS, MADRS) on 138 elderly patients were executed. In addition, based on the 61 patients of the 65 elderly patients (above 65 years old) with physical illness, except 4 patients who were severely cognitively impaired (MMSE-K score;below 19), sociodemographic data and health characteristic data were collected. The clinical diagnosis by DSM-IV diagnostic criteria and KGDS on 61 elderly patients were performed, and their functional disability caused by physical illness was evaluated. RESULTS: The frequency of depressive symptoms showed 50.0%, 36.2%, and 35.5%, respectively in KGDS, GDS, and MADRS. The patients with severe functional disability caused by physical illness-compared with those with mild functional disability-had significantly higher score on the depression scales (KGDS, GDS, MADRS). The correlation between severity of functional disability caused by physical illness and depression scales was highly positive. Severity of functional disability caused by physical illness was the strongest contributor to the depression scales. In the additional study, 19.7% of patients were diagnosed as major depressive disorder, 18% of them as dysthymic disorder, and depressive disorder (major depressive disorder & dysthymic disorder) group-compared with nondepressive disorder group-showed significantly higher score on the FDRPT and KGDS. CONCLUSION: The frequency of depressive symptoms and depressive disorder in elderly patients with physical illness was higher, compared with those in general elderly people. Functional disability caused by physical illness most highly influenced on depressive symptoms. Thus, it is important to discriminate whether the elderly patients with physical illness have depressive symptoms or not. In addition, we assumed that KGDS was not only highly correlated with other depression scales (GDS, MADRS), but also had the high diagnostic power of dis-crimination for depressive symptoms and depressive disorder. This study suggested that KGDS was available in screening depression in the elderly patients with physical illness. It was necessary to study systematically the availability of KGDS in the future.