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        "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Elaborar y validar una escala para detectar trastornos depresivos mayores &#40;TDM&#41; en ancianos que utilizan las consultas de atenci&#243;n primaria &#40;Escala para la Detecci&#243;n de Depresi&#243;n en Ancianos &#91;EDDA&#93;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio observacional transversal para validar una escala&#44; administrada mediante entrevista personal&#44; en 259 pacientes de 65 o m&#225;s a&#241;os&#46; Tras revisar los instrumentos disponibles y elaborar los &#237;tems&#44; se realiz&#243; una primera prueba piloto o pretest&#46; En una segunda prueba piloto se analiz&#243; la reproducibilidad del instrumento&#46; El est&#225;ndar de oro fue el resultado de una entrevista psiqui&#225;trica estandarizada realizada por psiquiatras &#40;criterios DSM-IV y entrevista SCAN&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Los coeficientes de correlaci&#243;n intraclase &#40;CCI&#41; correspondientes a la fiabilidad intra e interobservador fueron&#44; respectivamente&#44; de 0&#44;858 &#40;intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 0&#44;634-0&#44;946&#41; y 0&#44;908 &#40;IC del 95&#37;&#44; 0&#44;726-0&#44;969&#41;&#46; El n&#250;mero de sujetos v&#225;lidos para el estudio fue de 216 ancianos&#44; en quienes se realiz&#243;&#44; de forma ciega&#44; una valoraci&#243;n en consultas de atenci&#243;n primaria y de psiquiatr&#237;a&#46; En &#233;stas se objetiv&#243; la existencia de un TDM en 81 de ellos &#40;37&#44;5&#37;&#59; IC del 95&#37;&#44; 31&#44;1-44&#44;4&#41;&#46; La EDDA mostr&#243; una elevada coherencia interna &#40;&#945; de Cronbach &#61; 0&#44;79&#41;&#46; El an&#225;lisis factorial determin&#243; que exist&#237;an 8 factores capaces de explicar el 55&#44;8&#37; de la varianza total&#46; Para una puntuaci&#243;n mayor o igual a 15&#44; la EDDA presenta una sensibilidad del 90&#44;1&#37; &#40;IC del 95&#37;&#44; 80&#44;95-95&#44;33&#41;&#44; una especificidad del 74&#44;8&#37; &#40;IC del 95&#37;&#44; 66&#44;48-81&#44;71&#41; y un cociente de probabilidad positivo de 3&#44;58 &#40;IC del 95&#37;&#44; 2&#44;65-4&#44;83&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La EDDA es un instrumento cl&#237;nicamente &#250;til para la detectar los TDM de los ancianos en la atenci&#243;n primaria&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to design and validate a scale to detect major depressive disorders in elderly individuals in primary care &#40;Detection of Depression in the Elderly Scale &#91;DDES&#93;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed an observational and cross-sectional study for the validation of a scale&#44; administered by means of a personal interview&#44; in 259 patients aged 65 years old or older&#46; Available instruments were reviewed and the questions were designed&#46; Subsequently&#44; a first pilot study was performed&#46; In a second pilot study the reproducibility of the instrument was analyzed&#46; The gold standard was the result of a standardized psychiatric interview performed by psychiatrists &#40;DSM-IV criteria and SCAN interviews&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The intraclass correlation coefficients corresponding to the test-retest and inter-rater reliability were 0&#46;858 &#40;95&#37; confidence interval &#91;CI&#93;&#44; 0&#46;634-0&#46;946&#41; and 0&#46;908 &#40;95&#37; CI&#44; 0&#46;726-0&#46;969&#41; respectively&#46; Two hundred sixteen subjects underwent an assessment&#44; in which primary care and psychiatric evaluations were blinded&#46; Major depression was diagnosed in 81 patients &#40;37&#46;5&#37;&#59; 95&#37; CI&#44; 31&#46;1-44&#46;4&#41;&#46; The internal consistency of the DDES was good &#40;Cronbach&#39;s alpha &#61; 0&#46;79&#41;&#46; Exploratory factorial analysis revealed an 8-component structure &#40;55&#46;8&#37; of explained variance&#41;&#46; A cutoff score of 15 or more for the DDES showed sensitivity of 90&#46;1&#37; &#40;95&#37; CI&#44; 80&#46;95-95&#46;33&#41;&#44; specificity of 74&#46;8&#37; &#40;95&#37; CI&#44; 66&#46;48-81&#46;71&#41; and a likelihood ratio &#40;&#43;&#41; of 3&#46;58 &#40;95&#37; CI&#44; 2&#46;65-4&#46;83&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The DDES is a clinically useful instrument for the detection of major depression in elderly patients in primary care&#46;</p>"
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Vol. 19. Núm. 2.
Páginas 103-112 (marzo - abril 2005)
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Vol. 19. Núm. 2.
Páginas 103-112 (marzo - abril 2005)
Originales
Open Access
Diseño y validación de un cuestionario para la detección de depresión mayor en pacientes ancianos
Design and validation of a questionnaire for the detection of major depression in elderly patients
Visitas
1143
Jesús D. López-Torres-Hidalgoa,b,
Autor para correspondencia
jesusl@sescam.org

Correspondencia: Jesús López-Torres Hidalgo. Gerencia de Atención Primaria. Marqués de Villores, 6. 02001 Albacete. España.
, M. Pilar Galdón Blesac, Clotilde Fernández-Olanoa,c, Francisco Escobar-Rabadánb,c, Julio Montoya-Fernándezb,c, Clotilde Boix-Grasd, María J. Montes-Lozanob,e, Luis Víctor Blas-Hernándeze, María L. Cremades-Romeroe, José M. del Campo-del Campoc, Francisco Arnalich-Fernándezf,g
a Gerencia de Atención Primaria de Albacete. España
b Facultad de Medicina. Universidad de Castilla-La Mancha. Albacete. España
c Centro de Salud Universitario Zona IV de Albacete. España
d Unidad Docente de Medicina Familiar y Comunitaria. Albacete. España
e Complejo Hospitalario Universitario. Albacete. España
f Facultad de Medicina. Universidad Autónoma de Madrid. Madrid. España
g Hospital Universitario La Paz. Madrid. España
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen
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Estadísticas
Resumen
Fundamento y objetivo

Elaborar y validar una escala para detectar trastornos depresivos mayores (TDM) en ancianos que utilizan las consultas de atención primaria (Escala para la Detección de Depresión en Ancianos [EDDA]).

Métodos

Estudio observacional transversal para validar una escala, administrada mediante entrevista personal, en 259 pacientes de 65 o más años. Tras revisar los instrumentos disponibles y elaborar los ítems, se realizó una primera prueba piloto o pretest. En una segunda prueba piloto se analizó la reproducibilidad del instrumento. El estándar de oro fue el resultado de una entrevista psiquiátrica estandarizada realizada por psiquiatras (criterios DSM-IV y entrevista SCAN).

Resultados

Los coeficientes de correlación intraclase (CCI) correspondientes a la fiabilidad intra e interobservador fueron, respectivamente, de 0,858 (intervalo de confianza [IC] del 95%, 0,634-0,946) y 0,908 (IC del 95%, 0,726-0,969). El número de sujetos válidos para el estudio fue de 216 ancianos, en quienes se realizó, de forma ciega, una valoración en consultas de atención primaria y de psiquiatría. En éstas se objetivó la existencia de un TDM en 81 de ellos (37,5%; IC del 95%, 31,1-44,4). La EDDA mostró una elevada coherencia interna (α de Cronbach = 0,79). El análisis factorial determinó que existían 8 factores capaces de explicar el 55,8% de la varianza total. Para una puntuación mayor o igual a 15, la EDDA presenta una sensibilidad del 90,1% (IC del 95%, 80,95-95,33), una especificidad del 74,8% (IC del 95%, 66,48-81,71) y un cociente de probabilidad positivo de 3,58 (IC del 95%, 2,65-4,83).

Conclusiones

La EDDA es un instrumento clínicamente útil para la detectar los TDM de los ancianos en la atención primaria.

Palabras clave:
Atención primaria
Trastornos depresivos
Validez
Fiabilidad
Cuestionarios
Abstract
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.

Key words:
Primary care
Depressive disorders
Validity
Reliability
Questionnaires
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