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Validating a single-question depression measure among older adults

Published online by Cambridge University Press:  20 September 2017

Kyung-Duk Min ,
Heeran Chun ,
Il-Ho Kim  and
Sung-il Cho
Kyung-Duk Min
Affiliation:
Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
Heeran Chun*
Affiliation:
Department of Health Administration, Jungwon University, Goesan, Republic of Korea
Il-Ho Kim
Affiliation:
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
Sung-il Cho
Affiliation:
Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
*
Correspondence should be addressed to: Heeran Chun, Department of Health Administration, Jungwon University, 85 Munmu-ro Goesan-eup Goesan-gun Chungbuk, 28024, Republic of Korea. Phone: +82-43-830-8851; Fax: 82- 43-830-8115. Email: heeranchun@gmail.com.
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Abstract

Background:

A single-item depression measure may not be adequate in capturing the complex entity of mental health, despite wide use of this indicator in community studies. This study evaluated the accuracy of a single-question depression measure in comparison to two composite indices–the Center for Epidemiologic Studies Depression Scale (CESD) and the Geriatric Depression Scale (GDS).

Materials and methods:

A total of 800 elderly participants ranging from 60 to 89 years of age and residing in Seoul were recruited using a multistage sampling scheme in 2015. The survey was conducted by trained interviewers with a constructed questionnaire. Reliability and validity measures such as the Kappa index, sensitivity, specificity, PPV, NPV, and AUC were used to evaluate the accuracy of the single question measure. Socio-demographic group differences in accuracy were compared by age, sex, marital status, education, employment, and financial status.

Results:

The prevalence of depression by a single-question measure was much lower than those of CESD and GDS (5.5%, 12.3%, and 12.1%, respectively). The sensitivity of the single-item measure, based on CESD and GDS, was extremely low at 30.6% and 36.1%. In the subgroup analysis, however, there was a marked educational discrepancy in all accuracy measures; in sensitivity, people with a university degree or higher showed about 2.4 times higher sensitivity than those having only a primary school education.

Conclusions:

The results show that a single-question depression measure should be used with caution. In addition, the single-question measure could substantially underestimate depression among the risk group of older adults.

Keywords

depression measuresingle questioncomposite indexaccuracy
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 1 , January 2018 , pp. 69 - 76
Copyright
Copyright © International Psychogeriatric Association 2017 

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