Evaluation of a new screening instrument for psychological distress in postacute rehabilitation in older person

S. Grund*, M. Kilb, E. Breitinger, W. Hundsdorfer, H.G. Schafer, J.M.G.A. Schols, A.L. Gordon, J.M. Bauer, G.W. Alpers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)


Purpose Although psychological distress has a negative impact on functional recovery, institutionalisation and mortality rates, there is typically no established procedure to screen for psychological distress in geriatric rehabilitation. The aim of the study was to evaluate a brief single-item Verbal Numerical Rating Scale (VNRS-PD) as a screening tool for psychological distress in multimorbid geriatric rehabilitation patients. Methods In this cross-sectional study, N = 132 geriatric rehabilitation in-patients (M = 82 years old; 70.5% female) completed a verbal numerical rating scale (VNRS-PD) on satisfaction with their mood as well as the Hospital Anxiety and Depression Scale (HADS) and the short-form of the Geriatric Depression Scale (GDS). Based on the questionnaire data, the rehabilitation patients were classified as high or low in psychopathology. Using receiver-operating characteristic (ROC) curve analysis, optimal cutoff scores of the VNRS-PD were calculated for each questionnaire to detect significant psychological distress. Results Between 28.8% (HADS >= 18) and 43.9% (GDS >= 6) of the sample had above-cutoff questionnaire scores. The area under the curve (AUC) of the VNRS-PD varied from 0.785 (95%-CI 0.709-0.861) (GDS >= 6) and 0.790 (95%-CI 0.716-0.864) (HADS >= 18) to 0.807 (95%-CI 0.734-0.880) (GDS >= 7). A score of <= 5 in the VNRS-PD proved to be the cutoff with an optimal trade-off between sensitivity (0.776-0.867) and specificity (0.638-0.703). Conclusion The VNRS-PD may be a suitable screening instrument to detect patients with psychological distress in inpatient geriatric rehabilitation for and to initiate further diagnostics within a graduated psychodiagnostic scheme. This first step may help to identify older patients with psychological distress and mental disorders, to initiate targeted interventions. Further research is needed to replicate these findings in a larger sample.Key summary pointsAim To evaluate a single-item Verbal Numerical Rating Scale as an initial screening tool for psychological distress (VNRS-PD). Findings The VNRS-PD is feasible in the setting of inpatient geriatric rehabilitation and suitable to detect patients who need more detailed psychodiagnostic examination to identify potential psychological distress and mental disorders. Message This work supports a stepwise psychodiagnostic scheme in inpatient geriatric rehabilitation and other settings to identify possible need for interventions.
Original languageEnglish
Pages (from-to)243-251
Number of pages9
JournalEuropean Geriatric Medicine
Issue number1
Early online date12 Sept 2021
Publication statusPublished - Feb 2022


  • Psychological distress
  • Mental health
  • Single-item screener
  • Geriatric assessment
  • Postacute rehabilitation
  • Older person

Cite this