Clinical Usefulness of the Geriatric Depression Scale to Identify the Elderly at Risk of Suicide

Abstract

Objective: Population-based suicidal screening can be an important intervention method to reduce suicidal attempt rate in community. However, directly asking about suicidal behavior may be burdensome to non-mental health workers. This study aimed to evaluate the clinical usefulness of the Geriatric Depression Scale-15 (GDS-15) in identifying the elderly at risk of suicide in community.

Methods: Nine hundred forty-eight over 60 years of age participated in this study. All participants completed the GDS-15. A trained interviewer interviewed each participant for suicidality including suicidal ideation, plan, and prior attempt using the Structured Clinical Interview for DSM-IV.

Results: When the cut-off score of 10 in the GDS-15 was applied to identify the elderly at risk of suicide, the proportion of directly asking about suicidal behavior by non-mental health workers was reduced by 33.1%; however, 19.5% at risk of suicide were missed. When the cut-off was changed to 6, 100% at risk of suicide were covered by the GDS-15.

Conclusion: Screening for suicidality using GDS-15 is a promising way to reduce the proportion of directly asking about suicidal behavior by non-mental health workers among the high-risk suicidal elderly in a community setting.

Keywords: Elderly; Geriatric Depression Scale; Screening; Suicide.

Figure 1.

The Receiver Operating Characteristic (ROC) curves of the performance of the two-stage screening strategy in discriminating between participants at risk for suicide and those who are not. At risk for suicide refers to anyone who had planned or attempted suicide. *depression cut-off point (10), †cut-off point included 100% of those in at risk for suicide (6). GDS: Geriatric Depression Scale (GDS-15), AUC: area under the curve.