There are caveats to the results reported here. We measured depressive symptoms using validated instruments, such as the General Health Questionnaire and CES-D, and information on prescribed antidepressant medication use (26,29,49). These instruments are not designed to make a psychiatric diagnosis of first or recurrent major depression (26,29); they defined only partially overlapping case populations and some misclassification occurred because antidepressants are also prescribed for conditions other than depression. Nevertheless, the associations of manifest CHD and stroke with depressive symptoms in our study are in agreement with previous research linking vascular disease to depressive symptoms and clinical depression (4,35–38,44). Furthermore, in a validation study of 274 elderly participants from our cohort, sensitivity and specificity of the questionnaire measures with depression diagnosed based on structured psychiatric interview as the criterion are high, almost 90% for CES-D depressive symptoms and approximately 80% for GHQ symptoms.
validation study
274 elderly participants
elderly participants
the questionnaire measures
sensitivity and specificity
almost 90%
%
the questionnaire measures
sensitivity and specificity
approximately 80%
%