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Screening for Depression in Nursing Home Palliative Care Patients

Department of Geriatrics, Mount Sinai Medical Center, New York, New York and Columbia University College of Physicians and Surgeons/Harlem Hospital Center; Harlem Hospital, Department of Medicine, 506 Lenox Ave., 14th floor New York, NY 10037.

Melinda S. Lantz, MD

the Jewish Home and Hospital, New York, New York; the Mount Sinai School of Medicine, New York, New York

Antonios Likourezos, MA, MPH

the Mount Sinai School of Medicine, New York, New York; the Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York

Orah R. Burack, MA

the Jewish Home and Hospital, New York, New York

Eileen Chichin, PhD, RN

the Jewish Home and Hospital, New York, New York; the Mount Sinai School of Medicine, New York, New York

John Carter, MD

the Jewish Home and Hospital, New York, New York; the Mount Sinai School of Medicine, New York, New York

The purpose of the this study was to evaluate the existing tools for assessing depression in nursing home patients referred to palliative care services. The patients referred to palliative care were assessed for depression by a geriatric fellow and a psychiatrist (gold standard). The questions asked by the fellow were derived from the existing validated screening scales and diagnostic tools. The psychiatrist’s assessment had a strong agreement with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV;. = 0.400) and Geriatric Depression Scale (GDS;. = 0.462) and least agreement with the Cornell Scale for Depression in Dementia (CDS). However, depression in the most severe dementia patients (Mini-Mental State Examination = 0) was able to be assessed only by the CDS. Thus, although items from the DSM-IV and GDS may be used to ascertain depression in geriatric patients, to date there is no scale valid and reliable enough to effectively ascertain depression in the most severely demented patients.

Key Words: geriatrics • palliative care • depression • nursing home • screening

Journal of Geriatric Psychiatry and Neurology, Vol. 17, No. 4, 212-218 (2004)
DOI: 10.1177/0891988704269817


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