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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >The Clinical Utility of the Cornell Scale for Depression in Dementia as a Routine Assessment in Nursing Homes
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The Clinical Utility of the Cornell Scale for Depression in Dementia as a Routine Assessment in Nursing Homes

机译：康奈尔抑郁症抑郁量表的临床效用，作为在疗养院的常规评估

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Objective: To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes. Setting: 14 nursing homes in Sydney and Brisbane, Australia. Participants: 92 residents with a mean age of 85 years. Measurements: Consenting residents were assessed by care staff for depression using the CSDD as part of their routine assessment. Specialist clinicians conducted assessment of depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders for residents without dementia or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease for residents with dementia to establish expert clinical diagnoses of depression. The diagnostic performance of the staff completed CSDD was analyzed against expert diagnosis using receiver operating characteristic (ROC) curves. Results: The CSDD showed low diagnostic accuracy, with areas under the ROC curve being 0.69, 0.68 and 0.70 for the total sample, residents with dementia and residents without dementia, respectively. At the standard CSDD cutoff score, the sensitivity and specificity were 71% and 59% for the total sample, 69% and 57% for residents with dementia, and 75% and 61% for residents without dementia. The Youden index (for optimizing cut-points) suggested different depression cutoff scores for residents with and without dementia. Conclusion: When administered by nursing home staff the clinical utility of the CSDD is highly questionable in identifying depression. The complexity of the scale, the time required for collecting relevant information, and staff skills and knowledge of assessing depression in older people must be considered when using the CSDD in nursing homes.
机译：目的：探讨康奈尔抑郁症抑郁量表（CSDD）在疗养院中的临床效用。地点：澳大利亚悉尼和布里斯班的14家疗养院。参加人数：92名居民，平均年龄为85岁。测量：护理人员使用CSDD作为他们日常评估的一部分，对同意的居民进行了抑郁症评估。专职临床医生使用DSM-IV-TR轴I障碍的半结构临床诊断访谈（针对无痴呆症的居民）或针对痴呆症居民的阿尔茨海默氏病临时诊断标准对抑郁症进行评估，以建立抑郁症的专业临床诊断。使用接收器工作特性（ROC）曲线，对专家完成的CSDD的诊断性能进行了分析。结果：CSDD诊断准确性低，总样本，患有痴呆症的居民和没有痴呆症的居民的ROC曲线下面积分别为0.69、0.68和0.70。在标准的CSDD截止评分下，总样本的敏感性和特异性分别为71％和59％，患有痴呆症的居民为69％和57％，而没有痴呆症的居民为75％和61％。优登指数（用于优化临界点）建议患有和没有痴呆症的居民的抑郁抑郁临界值不同。结论：由疗养院工作人员进行管理时，CSDD的临床实用性在识别抑郁症方面存在很大疑问。在疗养院中使用CSDD时，必须考虑量表的复杂性，收集相关信息所需的时间以及员工技能和评估老年人抑郁症的知识。

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