In geriatric psychiatry, the Geriatric Depression Scale-15 (GDS-15) differs from PHQ-9 in an important way that makes it more suitable for older patients. Which statement is correct?
- A GDS-15 is better validated for severe depression than PHQ-9
- B GDS-15 includes items on neurovegetative symptoms (sleep, appetite, libido)
- C GDS-15 is preferred for patients with delirium
- D GDS-15 uses a yes/no response format and excludes somatic items confounded by physical illness ✓
Explanation
The GDS-15 uses a simple yes/no response format, which reduces cognitive burden in elderly patients, and deliberately excludes somatic symptoms (sleep disturbance, fatigue, appetite change, libido) that are frequently confounded by physical comorbidities in older adults. This makes it more specific for psychological depression in the geriatric population. A score >5/15 indicates probable depression; >10/15 indicates severe depression. PHQ-9 is validated for a broader adult population but includes somatic symptoms that can produce false positives in medically ill elderly patients. GDS-15 is NOT suitable for patients with significant cognitive impairment or delirium.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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