Prevalence and Associated Factors of Depression in Mild Cognitive Impairment

OBJECTIVE: The aims of this study were to investigate the prevalence of co-morbid depression and related factors of depression in mild cognitive impairment (MCI) patients. METHODS: Nine hundred and six MCI individuals were included in this study. Depression was defined as major and minor depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Depression-related demographic and clinical factors were also explored through multivariate logistic regression analysis. RESULTS: In MCI patients, the prevalence of depression as defined according to the DSM-IV diagnostic criteria was 1.8% for major depressive disorder, 11.4% for minor depressive disorder, and overall 13.2% for both. Multivariate logistic regression showed that increased prevalence of overall depression was associated with female gender and non-amnestic subtype of MCI. CONCLUSION: Our findings based on a large number of MCI subjects who visited memory clinic indicated that more than ten percent of MCI patients have comorbid depression. In addition, female and non-amnestic subtype of MCI patients seems to be more vulnerable to depression.

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.

Standardization of the Korean Version of the Geriatric Depression Scale: Reliability, Validity, and Factor Structure

OBJECTIVE: We developed a Revised Korean version of the Geriatric Depression Scale (GDS-KR) and examined its reliability, validity, and factor structures. We also estimated its optimal cutoff scores for major depressive disorder (MDD) and minor depressive disorder (MnDD) stratified by age and education. METHODS: The GDS-KR was administered to 888 subjects (61 MDD patients, 45 MnDD patients, and 782 normal elders). Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) and Hamilton Depression Rating Scale (HAM-D). The mean GDS-KR scores of the MDD patients, MnDD patients and normal elders were compared to evaluate its discriminant validity. To evaluate its construct validity, a principal component analysis with varimax rotation was performed. Receiver operator characteristic (ROC) curve analyses were performed to evaluate its diagnostic ability. RESULTS: Chronbach's coefficient alpha for the GDS-KR was 0.90 and the test-retest reliability was 0.91 (p<0.01). The Pearson correlation coefficients of the GDS-KR scores with the CES-D-K and HAM-D scores were 0.63 (p<0.01) and 0.56 (p<0.01), respectively. The GDS-KR consisted of 5 factors. The optimal cut-off scores of the GDS-KR were 16/17 for MDD only and 15/16 for both MDD and MnDD. The optimal cutoff scores of the GDS-KR were higher in the less educated and younger subjects. The diagnostic accuracy for MDD of the GDS-KR was higher than that of the CES-D. CONCLUSION: The GDS-KR was found to be a reliable and valid questionnaire for screening MDD and MnDD in late life.

Predictors for Subjective Memory Complaints in the Elderly: The Results from Korean Longitudinal Study on Health and Aging (KLoSHA) / 신경정신의학

OBJECTIVES: We investigated the predictors of subjective memory complaints in the community-dwelling normal elderly. METHODS: This study was conducted as a part of Korean Longitudinal Study on Health and Aging (KLoSHA). 747 nondemented community-dwelling elderly aged 65 years or older were recruited. All participants underwent clinical evaluation for dementia and psychiatric disorder conformed to the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Clinical Assessment Battery and Korean version of Mini-International Neuropsychiatric Interview, respectively. Word list recall test, frontal assessment battery, Mini Mental Status Examination (MMSE-KC) and Korean version of Geriatric depression scale (GDS-K) were administered to evaluate episodic memory, frontal function, global cognition and depression, respectively. Subjective memory complaint was defined in two different ways: worse than one's past (SMC-P) and worse than others of one's age (SMC-O). RESULTS: In highly educated elderly, minor depressive disorder (OR=7.23, 95% C.I.= 2.29-22.86) and frontal dysfunction (OR=2.48, 95% C.I.=1.29-4.77) significantly increased the risk of SMC-O. However, they did not influence the risk of SMC-P. In low educated elderly, both the minor depressive disorder and frontal dysfunction did not influence the risk of SMC-O as well as that of SMC-P. CONCLUSION: SMC-O can be a sensitive subjective recognition of mild depression and/or frontal dysfunction in highly educated normal elderly.

Depressive Disorders among the College Students: Prevalence, Risk Factors, Suicidal Behaviors and Dysfunctions / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the prevalence and correlates of major and minor depressive disorders in college students. METHODS: A cross-sectional study was completed on a sample of 906 students (507 men and 399 women) with the self-administered form of Korean version of Mini International Neuropsychiatric Interview (K-MINI). RESULTS: Estimated 12-month prevalence of major depressive disorder was 4.2% in men and 9.5% in women, and that of minor depressive disorder was 15.4% in men and 23.2% in women. The factors, 'female gender' and 'age of 20-21', were significantly associated with major depressive disorder. 'Poor adaptation to school' was significantly associated with major depressive disorder both in men and women, but 'poor interpersonal relationship' and 'history of school withdrawal' were associated only in men. Idea of self-injury and suicidal behaviors (suicidal ideation, plan and attempt) were significantly associated with major depressive disorder in women, but were not associated with minor depressive disorder. CONCLUSION: Major and minor depressive disorders are highly prevalent in the college students. Major depressive disorder was more associated with dysfunctions and suicidal behaviors than minor depressive disorder. Campus-based mental health service is needed for the high-risk students.