Comparison of the standard and structured interview guide for the Hamilton Depression Rating Scale in depressed geriatric inpatients.

The interrater reliability of the standard Hamilton Depression Rating Scale (Ham-D) and a structured interview guide for the Ham-D (the SIGH-D) were compared in a sample of 20 elderly inpatients with major depression. Each patient was independently interviewed by four raters; two used the standard 24-item Ham-D, and the other two used a 24-item modified version of the Structured Interview Guide for the Ham-D. Systematic counterbalancing of raters and scales and a stringent evaluation schedule were used to counter position effects, spontaneous symptom change, or diurnal variation. The modified SIGH-D produced uniformly higher item- and summary-scale reliabilities than the unstructured Ham-D.

Olfaction in neurodegenerative disease: a meta-analysis of olfactory functioning in Alzheimer's and Parkinson's diseases.

BACKGROUND: Olfactory deficits in Alzheimer's disease (AD) and idiopathic Parkinson's disease (PD) have been well established. OBJECTIVE: To clarify and review the literature by evaluating the evidence for olfactory deficits in 3 olfactory domains, including odor identification, recognition, and detection threshold. DATA SOURCES: A literature search of English-language studies of olfaction in AD, PD, and healthy controls was conducted via online databases (PsycInfo and MEDLINE) and reference lists from review articles. STUDY SELECTION: To meet selection criteria for meta-analysis, each study required a control group and complete and usable data. This review yielded 26 publications of olfactory identification, recognition, and/or detection threshold. Because of the inclusion of more than 1 relevant study of olfaction in several of these publications (eg, both identification and threshold assessed), 43 studies were ultimately appropriate for meta-analysis. DATA EXTRACTION: Effect sizes were calculated for each study by expressing differences between patient and control group means in SD units (Cohen's d). DATA SYNTHESIS: Extremely large effect sizes were shown across all tasks in both AD and PD groups. Both between-group analyses using the Mann-Whitney U test and within-group analyses using Friedman 2-way analysis of variance did not reveal any significant differences (all P > .30). CONCLUSIONS: As expected, severe deficits were found for both patients with AD and PD in each of the 3 olfactory domains relative to controls. However, no discriminating olfactory deficits were seen between patient groups or among the 3 measured olfactory domains, suggesting a similar disturbance in olfactory function between patients with AD and PD.

Olfactory identification in elderly schizophrenia and Alzheimer's disease.

In the present study we assessed olfactory identification ability using the University of Pennsylvania Smell Identification Test (UPSIT) in 16 elderly patients with schizophrenia (ES), 20 patients with a diagnosis of probable Alzheimer's disease (AD), and 20 healthy elderly controls (EC). Both patient groups exhibited marked deficits in UPSIT performance relative to controls. ES and AD patients with similar levels of general cognitive impairment did not differ on the UPSIT, suggesting that the two disorders may share a common dysfunction in olfactory brain regions. While there have been recent reports of greater olfactory impairment in males, neither patient group exhibited significant gender differences on the UPSIT.