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[Screening for depression in nursing homes: validity of the WHO (Five) Well-Being Index]
Antje-Kathrin Allgaier1, Iris Liwowsky, Dietmar Kramer
1Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Ludwig-Maximilians-Universität München, München. Antje.Allgaier@med.uni-muenchen.de
Objective:
Depression is common in nursing home residents, but is still underrecognized. Screening for depression could be a first step to increase recognition rates within this high-risk group. Therefore, we investigated the validity of the WHO (Five) Well-Being Index (WHO-5) for early detection of depression in nursing home residents.
Methods:
The Structural Clinical Interview for DSM-IV (SCID) was used as the gold standard for the validation of the WHO-5. The diagnoses covered in this assessment were both current major depression as well as minor depression according to DSM-IV research criteria.
Results:
In our sample of 92 nursing home residents in Munich aged 65-97 years, (73.9% female, 26.1% male) 14.1% fulfilled the criteria of major depression and again 14.1% fulfilled the criteria of minor depression in the SCID. Overall diagnostic validity (area under the ROC curve) of the WHO-5 was .90 (95% confidence interval: .84- .97). The best cut-off-point according to Youden's index yielded a sensitivity of .92 and a specificity of .79.
Conclusions:
The diagnostic accuracy of the WHO-5 in our study is promising. The WHO-5 might be an efficient screening tool for nursing home residents, but results have to be replicated in a larger sample.
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