UNCORRECTED PROOFS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 Validation of the Retardation Rating Scale for detecting depression in geriatric inpatients Sylvie Bonin-Guillaume 1,2 , Laeticia Sautel 2 , Christophe Demattei 2 , Elisabeth Jouve 2 and Olivier Blin 2 * 1 Service de Me ´decine Interne et Ge ´riatrie, Assistance Publique des Ho ˆpitaux de Marseille, Ho ˆpital Nord, 13915 Marseille Cedex 20, France 2 CPCET et Pharmacologie Clinique, Institut des Neurosciences Cognitives de la Me ´diterrane ´e, Faculte ´ de Me ´decine, Assistance Publique Ho ˆpitaux de Marseille, Ho ˆpital de la Timone, 13385 Marseille Cedex 5, France SUMMARY Objectives Validation in the elderly of the Retardation Rating Scale (RRS), which includes items related to motor and mental retardation but not vegetative items, and may be particularly well-suited for the diagnosis of depression in the elderly. Methods One hundred and sixty-five geriatric inpatients (105 depressed), aged 65 and over, without dementia, neuroleptic medication and increased risk of slowed mobility, were assessed with the RRS and three validated ‘gold-standard’ scales for geriatric depression (Hamilton Depression Rating Scale, Montgomery and Asberg Depression Rating Scale, Geriatric Depression Scale). Factor analysis used varimax rotation, Cronbach’s, Spearman’s and Ferguson’s coefficients and the Mann–Whitney U-test to evaluate construct and internal consistency. Convergent validity and Receiver Operating Characteristics curves were also analyzed. Results Factor analysis retained three interpretable domains: (1) motor items (45% of the variance); (2) mental items and (3) the cognitive items. Internal consistency was high (a ¼ 0.91). Each item was strongly correlated with the total RRS score and associated with depression. The RRS showed good convergent validity and its total score increased with depression severity. A cut-off score of 10 yielded 79% sensitivity and 80% specificity, with 80% of the patients properly classified, that is 15% more than standard observer scales. Conclusion RRS is a valid screening tool for depression and improves recognition of depression in geriatric inpatients. Copyright # 2006 John Wiley & Sons, Ltd. key words — psychomotor retardation; geriatric depression; Retardation Rating Scale; validation study INTRODUCTION Depression, one of the most frequent psychiatric disorders, affects 15% of the elderly in the community and 40–50% of those in nursing homes (Roberts et al., 1997; Bair, 1998). Depression in late life is a significant health care issue because of its poor prognosis (Blazer, 2003), and natural progression (Beekman et al., 2002), and greater use of health services (Koenig and Kuchibhatla, 1998), thereby increasing medical costs (Katon et al., 2003). In later life, depressive disorders fulfilling rigorous diagnosis criteria are relatively rare, while atypical presentations are common (Beekman et al., 1999; Blazer, 2002). Therefore, later life depression remains under diagnosed and hence undertreated (Charney et al., 2003). Thus, identification of specific symptoms and clinically useful assessment tools are needed to improve diagnosis of depression in elderly popu- lations. Psychomotor retardation (PMR) is a main feature of depressive illness in young adults and an important symptom in the psychiatric classification system (i.e. DSMIV, American Psychiatric Association, 1994). INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIARTY Int J Geriatr Psychiatry 2006; 21: 1–9. Published online in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/gps.1657 *Correspondence to: Dr O. Blin, CPCET et Pharmacologie Clin- ique, Institut des Neurosciences Cognitives de la Me ´diterrane ´e, Faculte ´ de Me ´decine, Assistance Publique Ho ˆpitaux de Marseille, Ho ˆpital de la Timone, 13385 Marseille Cedex 5, France. E-mail: olivier.blin@ap-hm.fr Copyright # 2006 John Wiley & Sons, Ltd. Received 15 August 2005 Accepted 28 June 2006