The Cornell Scale for Depression in Dementia (CSDD) is a way to screen for symptoms of depression in someone who has dementia. The Cornell Scale for Depression in Dementia (CSDD) is designed for the assessment of depression in older people with dementia who can at least. Biopsychosocial assessment tools for the elderly – Assessment summary sheet. Test: Cornell Scale for Depression in Dementia (CSDD). Year:
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Valid tools are needed to assess depression across the depdession of cognitive impairment in PD. Receiver operating characteristic curves tested the discriminant validity of the CSDD compared to the clinical diagnoses of major and minor depression.
The curve for symptomatic depression had an area under the curve of 0. There was no evidence for differential measurement with respect to cognitive impairment or any other demographic or clinical variables. This study suggests that the CSDD is a valid tool for identifying depressive disorders in PD patients across a spectrum of cognitive impairment.
As validation studies in PD have not been conducted, this study investigated the discriminant validity of the CSDD in a PD sample relative to a clinical assessment for depression. Demmentia with idiopathic PD were enrolled in a longitudinal research protocol with prospective brain donation to study motor, cognitive, psychiatric, and clinical-pathological features of PD. Participants or their powers of attorney gave written informed consent to participate.
Cornell Scale for Depression in Dementia (CSDD)
Only baseline data was used for this analysis. A complete CSDD and psychiatric diagnostic assessment were the only inclusion criteria for this analysis. Thus, data on inter-rater reliability and length of administration for the CSDD is not available. An inclusive symptom attribution approach was used for diagnosing depression and when completing the CSDD.
This approach rates all symptoms as related to depression, regardless depressin symptom overlap depressioj PD or other medical conditions. Depressive disorders in full remission asymptomatic were classified as non-depressed.
Cornell Scale for Depression in Dementia (CSDD)
Diagnoses of clinically significant cognitive impairment, defined according to DSM-IV-TR criteria for dementia or cognitive disorder NOS, were based on dementka aforementioned diagnostic interview in addition to a mental status exam. Indices deprewsion evaluated at cut-offs defined as the maximum sum of sensitivity and specificity.
Rates of cognitive impairment were comparable between the depressed csddd non-depressed groups. Additionally, participants with cognitive impairment had higher mean CSDD scores in both depression groups [Non-depressed: As shown in Table 2two cut-off points had near equivalent sums of sensitivity and specificity; one with higher sensitivity, the other higher specificity.
Performance of the CSDD was statistically similar across cognitive impairment groups when treated as a edpression variable for no cognitive impairment, cognitive disorder NOS, and dementia and when treated as a dichotomous variable for no cognitive impairment versus any cognitive impairment. Discriminant indices were unchanged when minor depression was excluded from the analyses.
Sensitivity, specificity, positive and negative predictive values at different scores for the Cornell Scale for Depression in Dementia. In this study, the CSDD was shown to be a valid tool for identifying clinically significant depressive disorders across the spectrum of cognitive dysfunction in patients with PD. The identified cut-off scores that maximized sensitivity and specificity are similar to those reported in non-PD samples.
In addition to being valid across a broad range of motor and cognitive symptom severity, the CSDD is applicable for identifying cases of depressiom and minor depression.
Yet, while CSDD scores distinguished depressed from non-depressed cases, they did not discriminate major and minor depressive disorders.
We note that the diagnosis of minor depression is not validated in PD and remains a research diagnosis in DSM. However, inclusion of this subgroup in these analyses provided additional information on the ability of the CSDD to identify mild depressive disturbances.
Even mild depression is clinically significant in PD as it is linked to greater physical disability and earlier initiation of symptomatic therapy for motor-related deficits. By contrast, the item Geriatric Depression Scale discriminates major and minor depressive disorders, but its application with respect to cognitive dysfunction in PD has not been established. The lack of validated diagnostic criteria for either depressive disorders or dementia in PD limits studies in this area and the ability to compare results across studies.
In keeping with the recommendations of a National Institute of Health workgroup on depression in PD, we used an inclusive approach for symptom assessment and diagnosis in order to enhance the sensitivity and reliability of diagnostic criteria.
In our study, the cognitive disorder NOS category captured cases that did not meet DSM criteria for dementia because of the absence of significant memory deficits. However, these cases would meet the criteria for dementia proposed in a recent report by the Movement Disorder Society. The quality of insight and awareness with respect to symptoms is often a concern when evaluating cognitively impaired patients.
Interviews with informants and observation-based depressive symptom rating scales may csvd the most valid and reliable way to document depressive symptoms in cognitively impaired patients. However, this approach may not be satisfactory in time-limited situations. The Geriatric Depression Dementoa, a brief self-report instrument, is a potential alternative that has been validated in other cognitively impaired populations, but, as above, has not been studied explicitly in PD-dementia.
In conclusion, the CSDD holds promise as a depression screening tool for use across the spectrum of cognitive function in PD. For clinicians, the CSDD assesses relatively straightforward and observable psychopathological phenomena. An inclusive approach to symptom attribution, as used in this study, simplifies its administration and facilitates ratings by non-psychiatric clinicians.
Further study of the CSDD is needed to recommend its use as a measure of depression severity or treatment response. Documentation depressikn Author Roles. National Center for Biotechnology InformationU. Author manuscript; available in PMC Feb Author information Copyright and License information Disclaimer.
CSDD – Cornell Scale for Depression in Dementia
The publisher’s final edited version of this article is available at Mov Disord. This article has been corrected. See other articles in PMC that cite the published article. Abstract Introduction Valid tools are needed to assess depression across the spectrum of cognitive csdc in PD.
Results The curve for symptomatic depression had an area under the curve of 0. Conclusion This study suggests that the CSDD is a valid tool for identifying depressive disorders in PD patients across a spectrum of cognitive impairment.
METHODS Participants with idiopathic PD were enrolled in a longitudinal research protocol with prospective brain donation to study motor, cognitive, psychiatric, and clinical-pathological features of PD. Table 1 Group Characteristics and Scale Scores. Open in a separate window. Mean SD, Range ; Two sample t-test. Table 2 Sensitivity, specificity, positive and negative predictive dcale at different scores for the Cornell Scale for Depression in Dementia.
This cut-off criterion is a mathematical representation scwle the best simultaneous combination of sensitivity and specificity that is possible given the data.
It is useful in evaluating the validity of rating scales and comparing results across studies. In practice, clinicians and researchers should choose cut-off scores that reflect the purpose of depression assessment e. Discussion In this study, the CSDD was shown to be a valid tool for identifying clinically significant depressive disorders across the spectrum of cognitive dysfunction in patients with PD.
Footnotes Documentation of Cadd Roles Research project: Writing of the first draft-James R. Review and Critique-Laura Marsh, M.
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