Screening, Detection and Management of Depression in Elderly Primary Care Attenders. I: The Acceptability and Performance of the 15 Item Geriatric Depression Scale (GDS15) and the Development of Short Versions

One-hundred and ninety-eight elderly subjects attending theirgeneral practitioners (GPs) were asked to complete the 15 itemGeriatric Depression Scale (GDS15). Analysable results wereobtained from 194 (98%). Of these, 67 (34%) scored above theGDS15 cut-off (4/5) for significant depressive symptomatology.87.6% found the questionnaire to be acceptable and only 3.6%found it very difficult or very stressful. The GDS15 had a highlevel of internal consistency (Cronbach's alpha = 0.80). Allthe individual items of the GDS15 associated significantly (P<0.01) with total score and ‘caseness’. A singlequestion "do you feel that your life is empty?" identified 84%of ‘cases’. In an attempt to devise short scalesto screen elderly primary care patients for depression, thedata were subjected to logistic regression analysis. Ten (GDS10),four (GDS4) and one (GDS1) item versions were generated. Agreementbetween these short scales and the GDS15 in the original samplewas 95, 91 and 79% respectively. Cronbach's alpha was 0.72 forthe GDS10 and 0.55 for the GDS4. The short scales were thenvalidated in an independent sample of 120 patients in whom bothGDS data and the results of a detailed psychiatric interview(the Geriatric Mental Status Schedule, GMS) were available.The sensitivity and specificity of the GDS10 against GMS casenesswere 87 and 77% (cut-off 3/4); those of the GDS4 were 89 and65% (cut-off 0/1) and 61 and 81% (cut-off 1/2). Sensitivityand specificity for the GDS1 were 59 and 75%. It is concludedthat these short scales may be useful in helping GPs and practicestaff to identify elderly patients with significant depressivesymptoms.     

Assessing the Efficacy of Azaprophen and Physostigmine as a Pretreatment for Soman-Induced Incapacitation in Guinea Pigs by Response-Surface Modeling

Assessing the Efficacy of Azaprophen and Physostigmine as aPretreatment for Soman-lnduced Incapacitation in Guinea Pigsby Response-Surface Modeling. GENNINGS, C, CARTER, W. H., JR.,HARRIS, L. W., CARCHMAN, R. A., CAMPBELL, E. D., BOYLE, R. M.,TALBOT, B. G., AND SOLANA, R. P. (1990). Fundam. Appl. Toxicol.14, 235–242. Physostigmine (PHY) has the advantage overpyridostigmine of minimizing OP-induced incapacitation becauseit penetrates into the CNS. However, physostigmine is behaviorallytoxic at relatively low concentrations. It is anticipated thatthis could be offset by a cholinolytic to prevent behavioraldeficit due to the carbamate pretreatment alone. The therapeuticefficacy of physostigmine/azaprophen pretreatment therapy wasevaluated in soman-challenged guinea pigs. Response surfacemethodology was employed to describe the relationship of thepretreatment combination with duration of incapacitation. Thesignificance of the combination relative to PHY alone was evaluatedin addition to dose combinations that yield optimal time torecovery. Analysis of the fitted response surface indicatedthat combination pretreatment with these compounds significantlyreduces the time to recovery after soman challenge versus pretreatmentwith PHY alone.