[A scale for clinical evaluation of serotonergic deficit in elderly people]

In contrast to young adults, symptoms of serotonergic deficiency are relatively undocumented in elderly subjects. Specific abnormalities of serotonergic neurotransmission are nevertheless remarkable and have clinically important repercussions in affect, as well as in cognition and behavior. The aim of this study was to develop a scale for the clinical and transnosographic quantitation of serotonergic deficiency in elderly persons (5-HT scale). Based on the data in the literature and following a preliminary study, we developed a 10-point scale. The analysis into primary components, among 155 subjects, showed a stable factorial structure and highly saturated "pure" items (62 to 90) distributed into 4 factors: "loss of control", "anxiety-insomnia", "depression" and "disturbances of behavior". The factorial structure does not depend on the psychiatric diagnosis: the 5-HT scale is not correlated with the COVI anxiety scale, the Jouvent mood scale, the Widlocher slowing down scale or the Hamilton depression scale in the subgroup of depressed subjects. Factorial analysis on the cumulated items of the 5-HT and Hamilton depression scales shows dispersion of the items on the latter scale whereas those on the 5-HT retain a factorial distribution. These data seem to confirm the clinical importance of serotonin deficiency in elderly subjects and the pertinence of the transnosographic approach. The 5-HT scale, which still requires outside validation, would seem to contribute to the clinical evaluation of this deficiency.