Am J Psychiatry 1989; 146:1197-1200
Copyright © 1989 by American Psychiatric Association
Substituting nonsomatic for somatic symptoms in the diagnosis of depression in elderly male medical patients
SR Rapp and S Vrana
Behavioral Gerontology Program, VA Medical Center, Jackson, Miss.
The authors examined the sensitivity and specificity of a modified version
of the Research Diagnostic Criteria (RDC) for major, minor, and
intermittent depressive disorder in 150 elderly male medical inpatients.
Four somatic RDC symptoms were replaced with four nonsomatic symptoms. The
sensitivity of the modified criteria was 87%, the specificity was 97%, and
96% of patients were correctly classified. Misclassifications were of
mildly depressed patients. These results provide empirical support for the
use of alternative, nonsomatic depressive symptoms when somatic symptoms
are ambiguous indicators of depression.
