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Detection of depression in a rehabilitation environment
Abstract
Two studies investigated the utility of the Zung Self-Rating Depression Scale (SDS), the Center for Epidemiological Studies-Depression Scale (CES-D), and the Geriatric Depression Scale (GDS) in a rehabilitation environment. These three instruments allow for the examination of effects of the impact of items with somatic content. Since the GDS was developed to eliminate the effects of somatic concomitants of depression, it was hypothesized that it would serve as the best overall predictor of depression. Multiple regression and discriminant function analyses both pointed to the GDS as the best contributor to models assigning patients to depressed or non-depressed groups. Bayesian calculations of sensitivity, specificity, and predictive values also supported the use of the GDS among patients involved in acute rehabilitation programs. In addition, post-hoc analysis of sensitivity, specificity, and predictive values lent support to the use of the GDS as its hit rate most closely paralleled the expected base-rate of depression for the population of interest. Partial support was found for the hypothesis that the GDS will not significantly correlate with a priori identified somatic factors of the SDS and CES-D. That is, the GDS did not correlate with the somatic index from the SDS, but did with the index from the CES-D. The possibility that the CES-D factor labeled as somatic by Hertzog et al., (1990) may in fact be a more general factor was raised. Support for a two-factor model of the GDS did not obtain. Consideration is given to the possibility that the GDS is a uni-dimensional scale and therefore not amenable to factoring. Issues concerning the efficacy of allocation of mental health resources and the role of the GDS in the rehabilitation environment are discussed. Given the ability of the GDS to rule out depression, its easy answer format, and lack of items with somatic content, it appears to have the best overall utility in a rehabilitation environment.
Subject Area
Psychotherapy
Recommended Citation
Bohac, Daryl L, "Detection of depression in a rehabilitation environment" (1994). ETD collection for University of Nebraska-Lincoln. AAI9510962.
https://digitalcommons.unl.edu/dissertations/AAI9510962