Organization of depressive symptoms in the elderly population: hierarchical patterns and Guttman scales

Survey data from the US-UK Cross-National Geriatric Community Study was examined for hierarchical patterns in the organization of depressive symptomatology in the elderly population. A pattern similar to that previously found in a younger sample (Sturt, 1981) was evident. Low prevalence symptoms were associated with increased numbers of other symptoms. The poor fit of high-frequency somatic symptoms in this hierarchy was explained by their low specificity for depression in an elderly population. Derived Guttman scales of somatic and affective symptoms suggested, nonetheless, that such low-specificity symptoms may be clinically significant in the ontogeny of depression.