The Use of the Korean Version of Short Form Geriatric Depression Scale (SGDS-K)in the Community Dwelling Elderly in Korea

OBJECTIVES: The purpose of this study was to evaluate whether the diagnostic validity of the Korean version of short form (15 item version) Geriatric Depression Scale (SGDS-K) was maintained well in the community dwelling elderly. METHODS: In a face-to-face household survey conducted in Korea, 2,004 subjects aged more than 65 were interviewed by trained interviewers. 63 subjects diagnosed as dementia were excluded. The Mini Mental State Examination (MMSE) and SGDS-K were administered. Major depressive disorder (MDD) and minor depressive disorder (MnDD) were diagnosed with the diagnostic section of depressive disorder of the Korean version of the Composite International Diagnostic Interview (K-CIDI) according to DSM-IV diagnostic criteria. The sensitivity, the specificity and optimal cut-off point estimation and receiver operating characteristics (ROC) curve analysis were performed to investigate the diagnostic validity of the SGDS-K to screen MDD and MnDD. The diagnostic validity tests were also compared between two groups (with cognitive impairment and without cognitive impairment) divided by the MMSE scores. RESULTS: We suggest a score of 8 (sensitivity 0.9365, specificity 0.7603) as optimal cut-off score of SGDS-K for screening MDD and a score of 6 (sensitivity 0.7898, specificity 0.6586) as optimal cut-off score for screening both MDD and MnDD. The area under curve (AUC) was 0.900 for screening MDD and 0.797 for both MDD and MnDD. In the community dwelling elderly suffering from cognitive impairment, the sensitivity and specificity were 0.9500, 0.6870 with a cut off score of 8 for screening MDD and 0.8409, 0.5691 with a cut off score of 6 for screening both MDD and MnDD. The AUC was 0.893 for MDD and 0.767 for both MDD and MnDD. CONCLUSION: The SGDS-K was useful in screening MDD, both MDD and MnDD in the community dwelling elderly and also useful in the elderly suffering from cognitive impairment.

The Utility of Korean Version of the WHO Five Well-Being Index in Evaluating Depressive Symptoms and Quality of Life in the Aged Dwelling in Community

BACKGROUND AND OBJECTIVES: Recently the number of geriatric depressed people has been increasing tremendously. Among many factors affecting depression, quality of life seems to be closely related to depression. Thus, a screening tool for assessing both geriatric depression and quality of life is needed. The purpose of this study is to estimate the utility of the Korean version of the WHO-Five Well-Being Index (WHO-5) in evaluating geriatric depression as compared with SGDS-K (Short Geriatric Depression Scale of Korean version) that is being used widely and quality of life. METHODS: A sample of 244 subjects over 65-year old living in Yanggu and Inje area in Gangwon Province, Korea were interviewed and responded to scales, including WHO-5, SGDS-K, MMSE-KC (Mini Mental Status Examination in the Korean version of the CERAD assessment packet) and GQOL-D (Geriatric Quality of Life-Dementia). The total score of WHO-5 below 13 indicates low well-being. RESULTS: The WHO-5 inversely correlated with SGDS-K and positively with GQOL-D, but showed no significant correlation with MMSE-KC. The SGDS-K negatively correlated with WHO-5, MMSE-KC, and GQOL-D. Low well-being group (WHO-5 score<13) had lower GQOL-D score (t=1.9698, p<0.05) and higher SGDS-K score (t=1.9798, p<0.05) than high well-being group. In multiple regression analysis, WHO-5 was significantly associated with GQOL-D and SGDS-K (r2=0.29422, p=0.0000). CONCLUSION: The Korean version of WHO-5 was very useful to evaluate both depressive symptoms and quality of life in the aged dwelling in community.

The Prevalence and Related Factors of Depressive Symptoms among the Elderly in Rural Areas of Jeju Island

OBJECTIVE: Depressive disorder is one of the most frequent and serious neuropsychiatric disorders in the elderly. This study is aimed to investigate the prevalence and related factors of depressive symptoms among the elderly in rural areas of Jeju island. METHODS: The Short form of Geriatric Depression Scale (SGDS) and structured questionnaire about factors related with depression were administered to 590 rural-dwelling elderly in Jeju island. RESULTS: The overall prevalence of depressive symptoms over score 10 in SGDS is 16.6% (Male 14.2%, Female 17.8%). But there was no sex difference. And statistically significant factors related with depression by multiple logistic regression analysis were economic status, chronic physical illness, and self-perceived health status. Factor of physical limitations would be a possible associated one. CONCLUSIONS: The prevalence of depressive symptoms of Jeju island was nearly same as that of other areas. And several risk factors for depression were identified but further evaluation will be needed because of those complex and controversial findings.

Validation of Geriatric Depression Scale, Korean Version(GDS) in the Assessment of DSM-III-R Major Depression / 신경정신의학

OBJECTIVES: The authors attempted to evaluate the diagnostic validity of the Korean version, Geri-atric Depression Scale(GDS) for screening geriatric DSM-III-R major depression among clinical pop-ulations. METHODS: Through of preliminary trials 3 times, the authors translated GDS including Short form Geriatric Depression Scale(SGDS) into Korean. GDS, SGDS, HRS-D, CES-D was adminis-tered to 88 elderly psychiatric patients(35 major depressives, 51 were non-major depression) and also Diagnostic Interview Schedule(DIS-III-R) was administered independently to diagnoses DSM-III-R major depression. Reliability and validity test 5, optimal cut-off point estimation, and ROC curve analysis were done to investigate the diagnostic validity of GDS and SGDS. RESULTS: Internal consistency-reliability and concurrent validity of GDS, SGDS associated with other depression scales(HRS-D, CES-D) were excellent. Content validity and discriminant validity which differentiate DSM-III-R major depression from non-major depression was also good. The authors suggest the score '17' as the optimal cut-off point of GDS for screening DSM-III-R major depression among clinical populations and the score '8' as optimal cut-off score of SGDS. ROC curve analysis revealed wide AUC of both GDS and SGDS, which indicates its high diagnostic validity in assessing DSM-III-R major depression. The GDS and SGDS were found to be highly correlated(r=0.9594) and any difference of AUC between both scales in ROC curve analysis were not found. This finding suggests that SGDS can be an adequate substitute for GDS. CONCLUSION: The GDS and SGDS are valid and reliable case finding tools for screening DSM-III-R major depression among clinical populations in Korea but relatively high cut-off point demands the further evaluation in the viewpoint of culturally determined style of response for the depression questionnaire in Korea.

Prevalence of Cognitive Impairment and Depressive Symptoms among the Elderly in an Urban Community / 신경정신의학

OBJECTIVES: This study was to investigate the prevalence of cognitive impairment and depressive symptoms among the elderly in an urban community. METHODS: Korean version of Mini-Mental State Examination(MMSE-K), Short version of Geriatric Depression Scale(SGDS), and the Center for Epidemiologic Studies Depression(CES-D) were administered to 447 elderly persons(37.7% of all residents aged 65 and older) who resided in "Sanggye 10 Dong" by lay interviewers. Then a Psychiatrist and two Psychiatric residents interviewed the elderly scoring 23 or less on MMSE-K and diagnosed with dementia according to the criteria of DSM-III-R. RESULTS: The prevalence of cognitive impairment was estimated as 37.1%(male 18.8%, female 47.0%) by MMSE-Kor=25 and 15.8% by SGDS>or=10. Prevalences(CES-D>or=25) for the age groups 65 to 69, 70 to 74, 75 to 79, 80 to 84, and over 85 were, respectively 15.7%, 18.1%, 23.4%, 13.3%, and 23.5%. Caseness of depressive symptoms(CES-D >or= 25) was not related to sex, age, years of education, marital status, physical illness, occupation, living condition, and financial status. Of 166 persons who had cognitive impairment(MMSE-K