Purchase this article with an account.
Ashley Deemer, Robert W Massof, Judith E Goldstein; Predictive value of self-report psychological status in comparison to Geriatric Depression Scores in visually impaired patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4659.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Depression is a common co-morbidity among patients with visual impairment, yet detecting patients at risk can be time-consuming and cumbersome with administering formal questionnaires. Our objective is to determine the predictive value of self-report psychological status obtained through a single intake question as compared with the Geriatric Depression Scale (GDS).
A total of 764 patients were recruited from 28 low vision rehabilitation (LVR) centers in the United States. Eligibility criteria required participants to be new patients to the LVR center. Among the series of questionnaires that were administered via telephone before the initial clinical examination was a standardized “check-box” intake survey that included a single question asking patients to “describe their current emotional state” and the 15-item GDS. The GDS was used as the gold standard to assess depression severity and outcome variables were estimated using Rasch analysis.
Distributions of GDS severity measures of individual patients who reported being depressed, sad, anxious, and/or well-adjusted on the intake were greater than those who did not report the same symptom (p<0.005). A General Linear Model (GLM) was used to estimate the predictive weight of each of the self-report intake indicators. The binary indicator weights are: depressed (b=0.95, p=0.002; OR=2.58); sad (b=0.88, p=0.005; OR=2.42); anxious (b=0.82, p=0.005; OR=2.27); not well-adjusted (b=0.79, p=0.012; OR=2.21). When analyzing the within patient agreement between the depression indicator model and clinical depression diagnoses based on the GDS, a weighted kappa of 0.385 was estimated.
Patients who report that they are depressed, sad, anxious, and/or not well-adjusted on an intake questionnaire have greater level depression severity based on GDS measures than patients who do not report these symptoms. On a population basis, the GLM shows good separation of depression severity distributions between patients who report these psychological indictors vs those who do not. However, at the level of the individual patient, although kappa is significantly greater than zero, concordance between these indicators and a depression diagnosis based on GDS criterion is weak.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only