GERIATRIC DEPRESSION RATING SCALE (GDS)

The Geriatric Depression Scale was developed by Yesavage, Brink, Rose, Lum, Huang, Adey, and Leirer (1982). It was designed specifically for the aged, as a screening instrument for depression. The scale

  • Originally contained 100 items, but was condensed to 30 Is a self-administered test, but can be used in observer-administered formats also
  • The 30 items are yes/no questions.

Later, Sheik & Yesavage (1986) created a short form of the GDS (GDS-SF), which contained 15 items. The original can be referred to as the GDS- Long Form (GDS-LF). Literature is divided in terms of the short form being a suitable substitute (Aikman& Oehlert, 2001; Holroyd & Clayton, 2000).

Cut-off scores for different severities of depression are as follows:

For the long form: Normal 0 – 10, Mild 11 – 20, Moderate to Severe 21 – 30.

For the short form: Normal 0 – 4, Mild 5 – 9, Moderate to Severe 10 – 15.

Validation and Psychometric properties

The scale has a high degree of internal consistency, with a Chronbach’s alpha coefficient of .94, and split-half reliability score of .94. Test retest reliabilities of .85 (p < .001) for one week apart (Yesavage et. al., 1982) and .85 (p < .001) for one month apart (Parmelee, Lawton & Katz, 1989) show that within the time limits, scores reflect stable individual differences.

The GDS is a valid tool for discriminating symptom severity, and presence vs absence based on DSM-IV criteria, but not among different diagnostic groups. It should not be used as a single diagnostic measure (Watson, Zimmerman, Cohen, & Dominik, 2009).

The GDS has high correlations with the Zung Self-Rating Depression Scale (SDS) and the Hamilton Rating Scale for Depression (HRS-D) (.84 and .83 respectively); further evidence of validity.

Sensitivity (true positives) and specificity (true negatives) with a cutoff of 11 were 84% and 95% respectively, and they were 80% and 100% respectively at a cutoff of 14; providing evidence for scores of 11+ to be considered a possible indicator of depression.

Validity and reliability are unaffected by pertinent individual difference factors such as age, education, gender, race, and culture (Marc, Raue & Bruce, 2008; Rait et. al., 1999; Harralson et. al., 2002).

Critical Analysis

Overall, the GDS-LF is a reliable and valid measure of depression in aged individuals. It is…

  • Easy to administer (self-administered or observer)
  • A simple scale to complete (yes/no responses), especially for older adults
  • Useful in a variety of settings; nursing homes and the community, with medical inpatients, medical outpatients, and day-treatment clients
  • Shown to maintain it’s reliability and validity when administered by phone (Burke, Roccaforte, Wengel, Conley & Potter (1995)
  • Adequate in screening mildly demented subjects (McGivney, Mulvihill & Taylor, 1994)

Its few weaknesses include the possibility of over-diagnosing depression (Lesher & Berryhill, 1994), the inclusion of items/terms that could be seen as western value judgments (Sansoni et. al., 2007) and that it is not a useful or valid tool for screening cognitively impaired patients (Holroyd & Clayton, 2000).

(to be completed by a trained clinician)
       DATE:           TIME (24hr): 
Choose the best answer for how you have felt over the past week:
Yes / No
[]   []   1. Are you basically satisfied with your life?
[]   []   2. Have you dr‎opped many of your activities and interests?
[]   []   3. Do you feel that your life is empty?
[]   []   4. Do you often get bored?
[]   []   5. Are you in good spirits most of the time?
[]   []   6. Are you afraid that something bad is going to happen to you?
[]   []   7. Do you feel happy most of the time?
[]   []   8. Do you often feel helpless?
[]   []   9. Do you prefer to stay at home‚ rather than going out and doing new things?
[]   [] 10. Do you feel you have more problems with memory than most?
[]   [] 11. Do you think it is wonderful to be alive now
[]   [] 12. Do you feel pretty worthless the way you are now
[]   [] 13. Do you feel full of energy?
[]   [] 14. Do you feel that your situation is hopeless?
[]   [] 15. Do you think that most people are better off than you are
1. Are you basically satisfied with your life? Y / N
2. Have you dr‎opped many of your activities and interests? Y / N
3. Do you feel that your life is empty? Y / N
4. Do you often get bored? Y / N
5. Are you hopeful about the future? Y / N
6. Are you bothered by thoughts you can't get out of your head? Y / N
7. Are you in good spirits most of the time? Y / N
8. Are you afraid that something bad is going to happen to you? Y / N
9. Do you feel happy most of the time? Y / N
10. Do you often feel helpless? Y / N
11. Do you often get restless and fidgety? Y / N
12. Do you prefer to stay at home‚ rather than going out and doing new things? Y / N
13. Do you frequently worry about the future? Y / N
14. Do you feel you have more problems with memory than most? Y / N
15. Do you think it is wonderful to be alive now? Y / N
16. Do you often feel downhearted and blue? Y / N
17. Do you feel pretty worthless the way you are now? Y / N
18. Do you worry a lot about the past? Y / N
19. Do you find life very exciting? Y / N
20. Is it hard for you to get started on new projects? Y / N
21. Do you feel full of energy? Y / N
22. Do you feel that your situation is hopeless? Y / N
23. Do you think that most people are better off than you are? Y / N
24. Do you frequently get upset over little things? Y / N
25. Do you frequently feel like crying? Y / N
26. Do you have trouble concentrating? Y / N
27. Do you enjoy getting up in the morning? Y / N
28. Do you prefer to avoid social gatherings? Y / N
29. Is it easy for you to make decisions? Y / N
30. Is your mind as clear as it used to be? Y / N
 
This instrument can be found pages 24-25 of Compendium of Clinical Measures for Community Rehabilitation‚ available online at: http://www.health.qld.gov.au/qhcrwp/docs/clinical_measure.pdf
 
GDS maximum score = 15
0   -     4    normal‚ depending on age‚ education‚ complaints
5   -     8    mild
8   -   11    moderate
12 - 15    severe
 
1. no 2. yes 3. yes 4. yes 5. no 6. yes 7. no 8. yes 9. no 10. yes 11. yes 12. yes 13. yes 14. yes 15. no 16. yes 17. yes 18. yes 19. no 20. yes 21. no 22. yes 23. yes 24. yes 25. yes 26. yes 27. no 28. yes 29. no 30. no
Normal 0-9 Mild depressives 10-19 Severe depressives 20-30
 
Seyed Kazem Malakouti1*‚ Paridokht Fatollahi2 ‚ Arash Mirabzadeh3 ‚ Mojgan Salavati3 and Taher Zandi4. Reliability‚ validity and factor structure of the GDS-15 in Iranian elderly. INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY. Int J Geriatr Psychiatry 2006; 21: 588–593.
Department of Psychiatry‚ Iran University of Medical Sciences
Ministry of Oil‚ Health Department‚ Iran
Department of Psychiatry‚ University of Welfare and Social Sciences‚ Iran
State University of New York‚ Distinguished Professor‚ Director of Mood and Memory Clinic
Farsi GDS-15 Article in .pdf format from Dr. Robab Sahaf‚ Assistant Professor of the Iranian Resech Centre on Ageing‚ Rofeideh Rehabilitation Centre‚ University of Social Welfare and Rehabilitation Sciences‚ Koodakyar Ave‚ Daneshjoo Blvd‚ Velenjak‚ Tehran‚ Iran [email protected] .
 

BRINK‚ T. A.‚ YESAVAGE‚ J. A.‚ LUM‚ O.‚ HEERSEMA‚ P.‚ ADEY‚ M. and ROSE‚ T. L. (1982) Screening tests for geriatric depression. Clin Gerontologist 1‚37-44.

YESAVAGE‚ JEROME A.‚ BRINK‚ T. L.‚ ROSE‚ T.L.‚ LUM‚ O.‚ HUANG‚ V.‚ ADEY‚ M. and LEIRER‚ VON O. (1983)   DEVELOPMENT AND VALIDATION OF A GERIATRIC DEPRESSION SCREENING SCALE: A PRELIMINARY REPORT. J Psychiatr Res. 1982-1983;17(1):37-49.

Sheikh JI‚ Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986 June;5(1/2):165-173.

• Yesavage JA. Geriatric Depression Scale. Psychopharmacol Bull. 1988;24(4):709-711.

• Yesavage JA‚ Brink TL‚ Rose TL‚ et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-83;17(1):37-49.