Autor: |
Ten, Edmond, Ringman, John M., Ross, Leslie K., Mulnar, Ruth A., Dick, Malcolm B., Bartzokis, George, Davies, Helen D., Galask, Douglas, Hewet, Linda, Mungas, Dan, Ree, Bruce R., Schneider, Lon S., Segal-Gidan, Freddi, Yaffe, Kristine, Cummings, Jeffrey L. |
Zdroj: |
American Journal of Geriatric Psychiatry; Jun2008, Vol. 16 Issue 6, p469-477, 9p, 3 Charts, 3 Graphs |
Abstrakt: |
Objective: To compare the rates of depression in Alzheimer Disease (AD) determined using National Institute of Mental Health (NIMH) provisional criteria for depression in AD (NIMH-dAD) to those determined using other established depression assessment tools. Design: Descriptive longitudinal cohort study. Setting: The Alzheimer's Disease Research Centers of California. Participants: A cohort of 101 patients meeting NINDS-ADRDA criteria for possible/probable AD, intentionally selected to increase the frequency of depression at baseline. Measurements: Depression was diagnosed at baseline and after 3 months using NIMH-dAD criteria and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I Disorders. Depressive symptoms also were assessed with the Cornell Scale for Depression in Dementia (CSDD), the Geriatric Depression Scale (GDS), and the Neuropsychiatric Inventory Questionnaire. Results: The baseline frequency of depression using NIMH-dAD criteria (44%) was higher than that obtained using DSM-IV criteria for major depression (14%; Z = -5.50, df = 101, p <0.001) and major or minor depression (36%; Z = -2.86, df = 101, p = 0.021) or using established cut-offs for the CSDD (30%; Z = -2.86, df = 101,p = 0.004) or GDS (33%; Z = -2.04, df = 101, p = 0.041). The NIMH-dAD criteria correctly identified all patients meeting DSM-IV criteria for major depression, and correlated well with DSM-IV criteria for major or minor depression (κ = 0.753, p <0.001), exhibiting 94% sensitivity and 85% specificity. The higher rates of depression found with NIMH-dAD criteria derived primarily from its less stringent requirements for the frequency and duration of symptoms. Remission rates at 3 months were similar across instruments. Conclusions: The NIMH-dAD criteria identify a greater proportion of AD patients as depressed than several other established tools. [ABSTRACT FROM AUTHOR] |
Databáze: |
Supplemental Index |
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