Respond To The Post Below By Comparing Your Assessment Tool

Respond To The Post Bellowby Comparing Your Assessment Tool To Theirs

Respond to the post below by comparing your assessment tool to theirs. NOTE: my assessment tool: The patient Health Questionnaire (PHQ-9) Main Post For the purpose of this discussion, the assessment tool that shall be analyzed is the Geriatric Depression Scale . It is important to note that depression in elderly patients is a common problem and this leads to significant emotional suffering and loss of quality of life. Depression in elderly patients also lead to increase in the risk of physical inactivity as well as disability. As elderly persons grow older an get to the age of 80 and above, depression becomes prevalent especially if they live in nursing homes or if they suffer from dementia (Conradsson, Rosendahl, Littbrand, Gustafson, Olofsson & Lovheim, 2013).

Unfortunately, regardless of the fast that depression is more common than dementia in old age, it remains underdiagnosed and undertreated (Allan, Valkanova & Ebmeier, 2014). It is because of this that there is need to have a proper tool for diagnosing depression in geriatric patients. The tool should be effective in regard to the assessment process and help in the evaluation of treatment in order to monitor progress. One such tool is the Geriatric Depression Scale. The Geriatric Depression Scale is a tool that is used to assess elderly patients with a view of establishing whether they are depressed.

The tool was developed by Yesavage et al. in 1983. At the time it was established, it had 30 items. However, 30 items were found to be too many to be effective. The items made the tool time consuming for both elderly patients as well as clinicians. This necessitated the formulation of the GDS-15 which is said to be effective in diagnosing depression in elderly patients (Durmaz, Soysal, Ellidokuz & Isik, 2018).

The effectiveness of this tool has been researched widely and scholars have established that it is not only effective in diagnosing depression in elderly patients, but it also has a significant correlation with DSM-5 criteria in patients that have depression (Durmaz, Soysal, Ellidokuz & Isik, 2018). Psychometric properties mean that a tool is valid and reliable. It means that it has to be accurate in assessing what it is meant to assess, and it should also be consistent in providing results (Asunta, Viholainen, Ahonen & Rintala, 2019). The psychometric properties of the GDS-15 has been assessed in different studies. In fact, in one study, these properties were assessed in regard to different elderly populations including those that are cognitively intact, those that are functionally impaired and primary care elderly patients that are community dwelling.

The study established that the tool’s internal consistency reliability was moderate but acceptable. There was construct validity in the tool’s ability to measure depressed mood, suicidal ideation and life satisfaction. The ability of the tool to show the difference between patients that were depressed and those that were not depressed showed acceptable specificity and sensitivity. However, when it came to suicide attempt status, the scale showed significant weakness. In conclusion, the scholars pointed out that in all the geriatric populations that were included in the study, the scale showed impressive psychometric properties (Friedman, Heisel & Delavan, 2005).

This scale basically has 15 questions. They are easy to understand and answer for elderly patients. They all have yes or no answers. 10 questions have to be answered as Yes to attract a point and 5 questions have to be answered as No to attract a point. A score below 4 is normal.

A scale between 5-8 is mild depression. A score of 9-11 show moderate depression and a scale between 12-15 indicates severe depression. This is an assessment tool that should be applied in all geriatric patients and especially those that are not cognitively impaired. Since the scale can be adjusted depending on what the patient feels, it means that it can be used in the assessment of the effectiveness of a psychopharmacological therapy in patients. References Allan, C. E., Valkanova, V., & Ebmeier, K. P. (2014). Depression in older people is underdiagnosed. The Practitioner, ), 19-22 Asunta, P., Viholainen, H., Ahonen, T., & Rintala, P. (2019). Psychometric properties of observational tools for identifying motor difficulties–a systematic review. BMC pediatrics, 19(1), 322 Conradsson, M., Rosendahl, E., Littbrand, H., Gustafson, Y., Olofsson, B., & Là¶vheim, H. (2013). Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging & mental health, 17(5), Durmaz, B., Soysal, P., Ellidokuz, H., & Isik, A. T. (2018). Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. Northern clinics of Istanbul, 5(3), 216 Friedman, B., Heisel, M. J., & Delavan, R. L. (2005). Psychometric properties of the 15â€item geriatric depression scale in functionally impaired, cognitively intact, communityâ€dwelling elderly primary care patients. Journal of the American Geriatrics Society, 53(9),

Paper For Above instruction

The assessment of depression in elderly populations is a vital aspect of mental health care, considering the significant prevalence and impact of depression on this demographic. Numerous tools exist to screen for depression, each with its strengths and limitations. In comparing the Geriatric Depression Scale (GDS-15) with the Patient Health Questionnaire (PHQ-9), it is essential to evaluate their applicability, psychometric properties, ease of use, and clinical utility in geriatric populations.

Overview of the Geriatric Depression Scale (GDS-15)

The GDS-15, developed by Yesavage et al. in 1983, is specifically designed for elderly patients. Its design reflects considerations of cognitive load and simplicity, featuring 15 yes/no questions that are easy to comprehend and answer. The brevity of the GDS-15 allows for quick screening in various settings, particularly in primary care and community-dwelling elderly populations (Friedman, Heisel & Delavan, 2005). Its scoring system categorizes depression severity based on the total score, facilitating clinical decisions about the need for further assessment or intervention. Psychometrically, the GDS-15 has demonstrated acceptable reliability and validity across diverse elderly populations, including those with cognitive impairments (Conradsson et al., 2013). However, its focus is primarily on depressive symptoms without extensive coverage of comorbidities or other mental health issues often seen in older adults.

Overview of the PHQ-9

The Patient Health Questionnaire-9 (PHQ-9), developed as a broader patient-centered depression screening tool, consists of nine items aligned with DSM-5 criteria for major depressive disorder. Its design is concise yet comprehensive, asking patients about the presence and severity of symptoms over the past two weeks. The PHQ-9 not only assesses depression severity but also facilitates monitoring treatment progress, owing to its scoring system which permits categorization into minimal, mild, moderate, moderately severe, and severe depression (Kroenke et al., 2001). Its psychometric properties are well established in various populations, including elderly patients, demonstrating high sensitivity and specificity, especially when used in primary care settings (Thombs et al., 2008). Its questions are self-rated, which may require cognitive or literacy abilities depending on the patient.

Comparison of the GDS-15 and PHQ-9

Both the GDS-15 and PHQ-9 are validated screening tools for depression, but they differ in structure, scope, and application. The GDS-15 is designed explicitly for elderly populations, emphasizing simplicity with yes/no answers, reducing the cognitive burden. Its focus is on depressive symptoms relevant to older adults, and it has been extensively validated for geriatric populations with notable reliability (Conradsson et al., 2013). Conversely, the PHQ-9 is more general and applicable across varied age groups and clinical settings. Its alignment with DSM-5 criteria offers a closer approximation to clinical diagnoses, making it suitable for diagnostic purposes as well as monitoring (Kroenke et al., 2001). It provides a symptom severity measure, which is advantageous in tracking treatment outcomes.

Strengths and Limitations

The GDS-15’s strengths lie in its simplicity and specificity for geriatric patients. Its yes/no response format reduces ambiguity and is less cognitively demanding, which is essential in elderly populations with varying cognitive capacities. However, its primary limitation is potential reduction in sensitivity to symptoms that are not explicitly covered by its questions, such as neurovegetative symptoms commonly assessed in the PHQ-9.

The PHQ-9’s strengths include its comprehensiveness and direct connection to DSM-5 criteria, which enhances diagnostic accuracy and facilitates treatment monitoring. Its self-rating format can be both an advantage in terms of efficiency and a limitation when cognitive impairment reduces valid responses, wherein interviewer-administered formats might be preferable. Moreover, the PHQ-9's broader scope might incorporate symptoms less relevant to older adults, potentially impacting specificity (Thombs et al., 2008).

Clinical Implications and Suitability

In clinical practice, the choice between GDS-15 and PHQ-9 depends on the setting and patient population. For elderly patients with cognitive impairments or limited literacy, the GDS-15’s simplicity and yes/no format make it more suitable. Its validation in geriatric populations lends credibility to its use for screening and initial assessment. Conversely, for comprehensive evaluation, especially when diagnosing major depression or monitoring treatment response in cognitively intact older adults, the PHQ-9 offers a more detailed symptom profile aligned with DSM-5 criteria. It also allows clinicians to evaluate the impact of depressive symptoms on functioning and plan targeted interventions.

Conclusion

Both the GDS-15 and PHQ-9 are valuable tools in geriatric depression assessment. The GDS-15’s design caters specifically to the elderly, minimizing cognitive load and focusing on age-relevant symptoms, making it ideal for quick screening in populations with potential cognitive impairment. The PHQ-9’s alignment with DSM-5 criteria and detailed symptom severity assessment make it more suitable for comprehensive evaluation and ongoing treatment monitoring in cognitively healthy elderly patients. Clinicians should consider patient cognitive status, literacy, and the purpose of assessment when selecting between these tools. Combining both tools might also enhance screening accuracy and clinical decision-making in complex cases.

References

  • Conradsson, M., et al. (2013). Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging & Mental Health, 17(5), 593-600.
  • Kroenke, K., et al. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613.
  • Thombs, B. D., et al. (2008). The Patient Health Questionnaire-9 for depression screening in primary care: A systematic review. CMAJ, 178(8), 1071-1079.
  • Yesavage, J. A., et al. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37-49.
  • Friedman, B., et al. (2005). Psychometric properties of the 15-item Geriatric Depression Scale in functionally impaired, cognitively intact, community-dwelling elderly primary care patients. Journal of the American Geriatrics Society, 53(9), 1570-1576.
  • Allan, C. E., Valkanova, V., & Ebmeier, K. P. (2014). Depression in older people is underdiagnosed. The Practitioner, 258(1774), 19-22.
  • Durmaz, B., et al. (2018). Validity and reliability of the Geriatric Depression Scale-15 (short form) in Turkish older adults. Northern Clinics of Istanbul, 5(3), 216-222.
  • Conradsson, M., et al. (2013). Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging & Mental Health, 17(5), 593-600.
  • Thombs, B. D., et al. (2008). The PHQ-9 for depression screening in primary care: Systematic review. Canadian Medical Association Journal, 178(8), 1071-1079.
  • Kroenke, K., et al. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613.

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