Psychiatric morbidity among residents in a home for the elderly in spain: Prevalence of disorder and validity of screening

All residents in a home for elderly validos (able) in Spain were interviewed and 101 completed the study. Non-medical interviewers adminstered the GHQ-28 items and either Zung's Self-Rating Depression Scale (SDS) (N=69) or the Geriatric Depression Rating Scale (GDS) (N=31). The residents were also examined blind by psychiatrists standardized in the use of the Clinical Interview Scale (CIS), who also administered the ‘Mini-Examen Cognoscitivo’, the Spanish version of the Mini-Mental State Examination (MMSE), and diagnosed the identified ‘cases’ according to ICD-9 criteria. Twenty-one residents (20.8%) were considered to be ‘cases’ on the basis of the CIS; 14 (13.9%) were diagnosed as depressed and only four (4%) were diagnosed as being demented, although the mean age of the sample was 81.9 years (SD=5.6). Most ‘cases’; were of mild intensity and the differences with ‘non-cases’; seemed quantitative rather than qualitative. The GHQ-28 correctly identified 81.5% of ‘cases’; with a cutting score of 5/6 (sensitivity 70%, specificity 84.4%) and 77.4% of ‘cases’; with a cutting score of 4/5 (sensitivity 85%, specificity 75.3%), suggesting a discriminative power almost as good as in adult individuals. In the pilot study, the GDS performed better than the SDS as a screening instrument. The addition of the ‘Mini-Examen’ would have improved the sensitivity of both the GHQ-28 items and the SDS.