[Structured interview guide for evaluating depression in elderly patients, adapted from DSM IV and the GDS, HDRS and...

Depression in the elderly looks like depression in adulthood, without mention of a strict clinical specificity. In fact, depression in the elderly presents a semiologic inflexion, and a symptomatology attenuation. Some signs could be considered by others to twists as belonging the normal aging, but are in reality clinical elements of depression symptomatology. These reasons, as well as the variability of evaluation methods used, make that this pathology remains often underdiagnosed. Nevertheless, epidemiological studies have pointed out that this trouble is relatively frequent. Depression in the elderly is important to be detected, in reason that it could be treated, allowing to prevent somatic complications, repetition of troubles, relapse, suicide solution, and dementia development. Most of authors considers that the most useful diagnostic tests are screening assessments. In the geriatric population, about 43 tools exists for the depression, but some of these are better than other. Three validated rating scales are specially interessant for the depression in the elderly: GDS of Yesavage (Geriatric Depression Scale), HDRS of Hamilton (Hamilton Depression Rating Scale) and MADRS of Montgomery and Asberg (Montgomery and Asberg Depression Rating Scale). The purpose of this work is to present a psychiatric interview guide, allowing to better specify depressive symptoms with old subjects, constructed and adapted from these 3 rating scales and the DSM IV criteria. In order that, we have first synthetized all of the items of the 3 scales. Then, by following diagnostic criteria of the DSM IV, we have constructed with uniform manner the interview guide. It has been built to evaluate general clinical aspects, but also to precise clinical points. The interviewer can ask question, take into account the clinical dimension, and appreciate the intensity of the trouble. The guide has been experimented and tested with older depressive subjects. After a necessary training phase to control the assessment system, the guide is usable during a clinical interview. It allows to collect, in a standardized manner, sufficiently data to establish the diagnosis and to quantify the intensity of the trouble. Conceived initially for a practical clinic use, this guide will have future use in research studies, in return for some ulterior validation works.