Using a single question to screen for depression in the nursing home

Summary riatric depression scale (GDS) is the most common instrument for the evaluation of depression in the elderly, but some of its items do not easily fit with the nursing-home setting. Different short-version of the GDS have already been proposed, but they have shortcomings, too. This work was aimed at verifying the possibility of using a single question as a screening instrument for depression in the nursing-home population. The full-length Italian version of the GDS (GDS-30) was administered in a single nursing-home to all institutionalized women (61 patients) with a mini mental state examination (MMSE) score greater than 15. The results of the 30-item and of the 15-item versions were subsequently computed. Following a previous report, we identified the 16th item of the GDS-30 as the critical one for single-question screening. On the basis of the GDS-30, 24 women (39.3 %) had a score higher than 10. Using the GDS-30 as the criterion, the single-question had a sensitivity and a specificity of 95.8 and 83.8 %, respectively. By contrast, the GDS-15 had a lower sensitivity (79.2 %), although its specificity (97.3 %) was better. Given that sensitivity has higher value than specificity for the screening of highly impairing diseases, our results support a preference given to the single-question compared to the GDS-15. Moreover, the single question had almost the same accuracy as the GDS-30, without being time consuming and overcoming the difficulties of administration of the latter in the nursing home population.