Can the geriatric depression scale screen for suicidal ideation?

January 01, 0001

Can the geriatric depression scale screen for suicidal ideation?

Geriatric patients have higher rates of suicide, though they often do not bring up the issue. These Canadian and US researchers sought to assess the 15-item Geriatric Depression Scale (GDS) and its 5-item GDS suicidal ideation subscale (GDS-SI) as a screening tool. They tested this in a cross-sectional cohort of 626 primary care patients (235 men, 391 women) 65 years of age or older. The screening tests were compared with the Hamilton Rating Scale for Depression and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

The authors report: "Patients expressing suicide ideation (n = 69) scored higher on the GDS and GDS-SI than those who did not (n = 557). A GDS cut score of 4 maximized sensitivity (0.754) and specificity (0.815), producing an area under the curve of 0.844 and positive and negative predictive values of 0.335 and 0.964, respectively. Optimal cut scores were 5 for men and 3 for women. A GDS-SI cut score of 1 was optimal for the total sample and for both men and women."

The authors concluded: "The GDS and GDS-SI accurately identify older patients with suicide ideation. Research is needed to examine their acceptability and barriers to routine use in primary care."

This report suggests the geriatric depression scale and one of its subscales may be used as screening tests for suicidal ideation in geriatric patients, although further testing needs to be performed.

For the full abstract, click here.

The Journal of the American Board of Family Medicine 23(2:260-269 , March 2010
© 2010 American Board of Family Medicine
Screening for Suicide Ideation among Older Primary Care Patients. Marnin J. Heisel, Paul R. Duberstein, Jeffrey M. Lyness, and Mitchell D. Feldman. Correspondence to Marnin J. Heisel: [email protected]

Category: P. Psychological. Keywords: suicidal ideation, Geriatric Depression Scale, GDS, GDS-SI, screening, prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 21 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.