Development and validation of Geriatric Clinical Depression Rating Scale
Keywords:
depression, geriatric, GCDRS, diagnosis, clinical rating, Likert scaleAbstract
Aim &Objective: The aim of the study was to develop and standardize a clinically useful depression rating scale for the elderly. In diagnosing and leveling depression in the elderly, traditional rating scales offer limited use in clinical settings as they cannot provide the specific level of severity on the Likert scale, and also miss some common symptoms that are part of depression in the elderly; thereby putting constraints on adequate quantification of depressive symptoms and severity. A lengthy list of items proves time-consuming and tiring to the elderly. The current scale aims to overcome these shortcomings and to provide symptoms and severity for clinical use to make treatment decisions and diagnosis accurate.
Method: Based on a systematic review of literature, evaluation of popular depression rating scales, and discussion with experts, a list of items was generated on a Likert scale. Phase I-III of scale development, the items framed were evaluated for content and face validity, internal consistency, concurrent validity, and clinical cut-offs were established. The scale items were evaluated on two sample groups- one, from community-dwelling elderly persons (n=36) and another on the clinical sample (n=36) on patients visiting a geriatric mental health clinic in the out-patient department of tertiary care hospital.
Results: Cronbach’s alpha of the final 20-items of the scale for the clinical and non-clinical sample was .88 and .90, respectively. Concurrent validity as established with routinely used rating scale was .82 for the clinical sample and .96 for the non-clinical sample; both were significant at α0.01. The receiver operating characteristic curve was plotted for the clinical sample and area under the curve was 0.77, and the optimum cut point was identified as a score of 25.
Conclusion: Geriatric clinical depression rating scale (GCDRS) 20 item instrument with a cut-off of 25, validated on clinical as well as community elderly with high sensitivity and specificity in assessing the depressive symptoms domains on Likert scale and recommended to be used by the clinician for severity and diagnosis of depression among elderly.
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