Semi-structured Depression Scale Sensitive to Change with Treatment for Use in the Elderly

The construction of a semi-structured interview depression scale that is sensitive to change for use in the elderly is described. Depression items from a well validated diagnostic instrument, the Geriatric Mental State Schedule (GMSS), were used as the core items in the development of the instrument. Improvement in depression in 80 elderly patients was independently assessed with two standard rating scales for depression, the Hamilton Rating Scale for Depression and the Beck Depression Inventory, and by an independent clinician's judgement before and after standard antidepressant treatment. Depression items that were sensitive to change were retained from the core items to form the new instrument. Results indicate that this scale is reliable and valid, shows better correlation with both the clinician's and the patient's judgement of improvement than the standard instruments, and is sparing of the rater's time.