Using the Minimum Data Set 2.0 Mood Disturbance Items as a Self-Report Screening Instrument for Depression in Nursing Home Residents
University of Pennsylvania, Department of Psychiatry and Philadelphia VA Medical Center, Philadelphia, PA, USA. American Journal of Geriatric Psychiatry
(Impact Factor: 4.24).
02/2004; 12(1):43-9. DOI: 10.1097/00019442-200401000-00006
Seeking to enhance nursing home residents' involvement in their care, the authors examined whether the Minimum Data Set, Version 2.0 (MDS) Mood Disturbance items could be administered by self-report. They compared the MDS to the Geriatric Depression Scale (GDS) in terms of its association with depression diagnosis.
Subjects (N=204) were nursing home residents who were interviewed with a psychiatric diagnostic instrument, the GDS, and a self-report version of the MDS mood disturbance items.
Analyses of variance and receiver operating characteristics analyses demonstrated that MDS items distinguished subjects with any versus no depression about as well as did the GDS. This pattern held within cognitive, gender, and ethnicity subgroups.
The MDS Mood Disturbance items can be reliably and validly administered via self-report to persons scoring at least 12 on the Mini-Mental State Exam.
Available from: Anna Azulai
- "Differences between these scales may be due to differences in the scales' symptom content and the fact that GDS is self-reported and DRS observer-reported.Kohler et al. (2005)also noted a low correlation between the DRS and the CSDD, attributing it to different data collection strategies. Interestingly, Ruckdeschel, Thompson, Datto, Streim, andKatz (2004)converted the DRS into a self-report assessment and found high correlation with the GDS-30. In a cross-sectional study of nursing home patients (N = 204) with MMSE above 12, the converted version of the DRS performed well, producing sensitivity of 93%, specificity of 71%, PPV of 53, and NPV of 96 at the cut point of 3, against the DSM-IV diagnostic criteria as a gold standard. "
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ABSTRACT: Abstract Studies in residential care facilities suggest that routine screening can assist in the early detection of geriatric depression. However, the effectiveness of screening instruments in residential care in the US and Canada has not been adequately evaluated. We conducted a systematic narrative review of the English-language literature published between 2000 and 2010 on screening instruments used for depression detection in older adults living in residential care facilities. The review yielded nine scales and their modifications tested in residential care, which we evaluated. We provide specific recommendations for the use of effective scales and discuss implications for practice, policy and research.
Available from: gmcf.org
- "Detection characteristics were similar to the 15-item GDS. Recent reports have recommended using the MDS in concert with other measures, such as the GDS (Ruckdeschel et al., 2004; Snowden et al., 2003). "
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ABSTRACT: The assessment and treatment of depression in long-term care (LTC) settings poses unique challenges to both clinicians and researchers. In this review we discuss the variety of forms depression can take among LTC residents and the influence the LTC environment can play on the development and maintenance of depression. We describe instruments that can be used to assess depressive symptoms, along with their strengths and liabilities. Additionally, we summarize treatment approaches, with an emphasis on the relatively limited number of empirically informed interventions. Throughout, we describe modifications that may improve the accuracy of assessment and the effectiveness of psychological treatments. Depression, while common among LTC residents, appears amenable to psychological intervention, although the field is far from identifying empirically supported treatments in the LTC setting.
Available from: Richard N Jones
- "In their study, the CSDD was collected by primary caregivers, while the MDS was abstracted from the chart, and these authors suggest that the nurse administrators that completed the MDS did not consult the primary caregivers and the resident in completing the MDS depression items. Contrast with these findings a recent study by Ruckdeschel and colleagues , who converted the MDS items into a self-report assessment device and reported a very high correlation with depression symptom data collected with the GDS (r = 0.71). "
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ABSTRACT: The objective of this study was to examine the Minimum Data Set (MDS) and Geriatric Depression Scale (GDS) as measures of depression among nursing home residents.
The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1) a sum of the MDS Depression items; (2) the MDS Depression Rating Scale; (3) the 15-item GDS; and (4) the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant) across cognitive impairment strata.
The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment.
The MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression.
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