Screening Tests for Depression in Older Black vs. White Patients

Thirty-nine psychiatric patients age 50 and older with diagnoses of depression participated in a study of the reliability of screening instruments in the identification of depression. All patients had a diagnosis of affective disorder confirmed by a SCID interview. Forty-nine percent of the depressed patients were black, 51% were 70-92 years old, 77% were women, and 51% were widowed. When the Center for Epidemiologic Studies-Depression Scale (CES-D) was administered to these depressed patients, its sensitivity in black patients was 71% and in white patients was 85%. The sensitivity of the Geriatric Depression Scale (GDS) was 53% in black patients and 65% in white patients. The CES-D was significantly better than the GDS in the identification of depressive symptoms in this sample. These data suggest that the CES-D and the GDS may not be equally effective in identifying depression among older American black and white patients. Further studies with larger samples of SCID-diagnosed, depressed, older black and white patients are needed to confirm these findings.