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Test Characteristics of the 15-Item Geriatric Depression Scale and Hamilton Depression Rating Scale in Parkinson Disease

From the Departments of Psychiatry (DW, KAO, IRK) and Neurology (DW, MBS), University of Pennsylvania, Philadelphia, Pennsylvania, the Parkinson’s Disease Research, Education and Clinical Center (DW, MBS) and the Mental Illness Research, Education and Clinical Center (DW, IRK), Philadelphia Veterans Affairs Medical Center (PADRECC and MIRECC), Philadelphia, Pennsylvania.

Objective: The objective of this study was to compare the sensitivity, specificity, and diagnostic accuracy of the 15-item Geriatric Depression Scale (GDS-15) and the Hamilton Depression Rating Scale (HDRS) in patients with Parkinson disease (PD).

Method: A convenience sample of 148 outpatients with idiopathic PD receiving specialty care completed the GDS-15 and were administered the HDRS and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID) depression module by a research psychiatrist or trained research assistant. Receiver-operating characteristic (ROC) curves were plotted for the GDS-15 and HDRS scores with a SCID diagnosis of a depressive disorder as the state variable.

Results: Thirty-two subjects (22%) were diagnosed with a depressive disorder. The discriminant validity of the GDS-15 and HDRS were both high (ROC area under the curve: 0.92 and 0.91, respectively), with greatest dichotomization for the GDS-15 at a cutoff of 4/5 (87% accuracy, 88% sensitivity, 85% specificity) and the HDRS at a cutoff of 9/10 (83% accuracy, 88% sensitivity, 78% specificity).

Conclusions: The GDS-15 performs well as a screening instrument and in distinguishing depressed from nondepressed patients in PD. Its test characteristics are comparable to the HDRS. Because it is a brief instrument and can be self-administered, it is an excellent depression screening tool in this population.

Key Words: Parkinson disease • depression • Geriatric Depression Scale

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