An exploratory use of the Symptoms Checklist-90 in a mixed geriatric study group

There are currently no self-rating scales of general psychopathology in the older population. Such scales can be used to screen patients who may then be referred on for psychiatric assessment. The validity of the Symptoms Checklist-90 (SCL-90), a self-rating scale of general psychopathology widely used in the nongeriatric adult population, was explored in 44 older subjects. It was compared with the Sandoz Clinical Assessment Geriatric (SCAG) scale and a measure of functional disability, the London Psychogeriatric Rating Scale (LPRS). Caregivers to all subjects also rated the degree of difficulty experienced with their care on a four-point scale. Thirty of the subjects attended a geriatric day hospital, and the remaining 14 were waiting to go into long-term care facilities. Symptoms Checklist-90 was not significantly different between the two groups of subjects (day hospital and preinstitutional) after Bonferroni corrections, though SCAG scale and LPRS were (P less than .01 for both). Although SCL-90 was correlated significantly with the SCAG scale (r = .46), it was not significantly correlated with the LPRS. It showed good internal consistency but poor face validity and an inability to differentiate between levels of difficulty for the caregiver. It is concluded that the use of SCL-90 in older people may be limited because of the lack of sensitivity to functional disability and care difficulty. This nevertheless needs to be further explored, perhaps with some modification of the scale for older people.