A comparison of nine scales to detect depression in Parkinson disease: Which scale to use?

J. R. Williams, E. S. Hirsch, K. Anderson, A. L. Bush, S. R. Goldstein, S. Grill, S. Lehmann, J. T. Little, R. L. Margolis, J. Palanci, G. Pontone, H. Weiss, P. Rabins, L. Marsh

Research output: Contribution to journalArticlepeer-review

85 Scopus citations


Objective: The Methods of Optimal Depression Detection in Parkinson's Disease (MOOD-PD) study compared the psychometric properties of 9 depression scales to provide guidance on scale selection in Parkinson disease (PD). Methods: Patients with PD (n 229) from community-based neurology practices completed 6 self-report scales (Beck Depression Inventory [BDI]-II, Center for Epidemiologic Studies Depression Rating Scale-Revised [CESD-R], 30-item Geriatric Depression Scale [GDS-30], Inventory of Depressive Symptoms-Patient [IDS-SR], Patient Health Questionnaire-9 [PHQ-9], and Unified Parkinson's Disease Rating Scale [UPDRS]-Part I) and were administered 3 clinician-rated scales (17-item Hamilton Depression Rating Scale [HAM-D-17], Inventory of Depressive Symptoms- Clinician [IDS-C], and Montgomery-Asberg Depression Rating Scale [MADRS] and a psychiatric interview. DSM-IV-TR diagnoses were established by an expert panel blinded to the self-reported rating scale data. Receiver operating characteristic curves were used to estimate the area under the curve (AUC) of each scale. Results: All scales performed better than chance (AUC 0.75-0.85). Sensitivity ranged from 0.66 to 0.85 and specificity ranged from 0.60 to 0.88. The UPDRS Depression item had a smaller AUC than the BDI-II, HAM-D-17, IDS-C, and MADRS. The CESD-R also had a smaller AUC than the MADRS. The remaining AUCs were statistically similar. Conclusions: The GDS-30 may be the most efficient depression screening scale to use in PD because of its brevity, favorable psychometric properties, and lack of copyright protection. However, all scales studied, except for the UPDRS Depression, are valid screening tools when PD-specific cutoff scores are used.

Original languageEnglish (US)
Pages (from-to)998-1006
Number of pages9
Issue number13
StatePublished - Mar 27 2012

ASJC Scopus subject areas

  • Clinical Neurology


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