Dise？o y validación de un cuestionario para la detección de depresión mayor en pacientes ancianos

background and objective: the aim of this study was to design and validate a scale to detect major depressive disorders in elderly individuals in primary care (detection of depression in the elderly scale [ddes]). methods: we performed an observational and cross-sectional study for the validation of a scale, administered by means of a personal interview, in 259 patients aged 65 years old or older. available instruments were reviewed and the questions were designed. subsequently, a first pilot study was performed. in a second pilot study the reproducibility of the instrument was analyzed. the gold standard was the result of a standardized psychiatric interview performed by psychiatrists (dsm-iv criteria and scan interviews). results: the intraclass correlation coefficients corresponding to the test-retest and inter-rater reliability were 0.858 (95% confidence interval [ci], 0.634-0.946) and 0.908 (95% ci, 0.726-0.969) respectively. two hundred sixteen subjects underwent an assessment, in which primary care and psychiatric evaluations were blinded. major depression was diagnosed in 81 patients (37.5%; 95% ci, 31.1-44.4). the internal consistency of the ddes was good (cronbach's alpha = 0.79). exploratory factorial analysis revealed an 8-component structure (55.8% of explained variance). a cutoff score of 15 or more for the ddes showed sensitivity of 90.1% (95% ci, 80.95-95.33), specificity of 74.8% (95% ci, 66.48-81.71) and a likelihood ratio (+) of 3.58 (95% ci, 2.65-4.83). conclusions: the ddes is a clinically useful instrument for the detection of major depression in elderly patients in primary care.