Depression is common in nursing home residents, but is still underrecognized. Screening for depression could be a first step to increase recognition rates within this high-risk group.

Therefore, we investigated the validity of the WHO (Five) Well-Being Index (WHO-5) for early detection of depression in nursing home residents.

The Structural Clinical Interview for DSM-IV (SCID) was used as the gold standard for the validation of the WHO-5. The diagnoses covered in this assessment were both current major depression (MD) as well as minor depression (MinD) according to DSM-IV research criteria.

In our sample of 92 nursing home residents in Munich aged 65–97 years, (73.9% female, 26.1% male) 14.1% fulfilled the criteria of MinD, and again 14.1% fulfilled the criteria of MD in the SCID. Overall diagnostic validity (area under the ROC curve) of the WHO-5 was 90.1% (95% confidence interval: 83.5%–96.7%). The World Health Organization's recommended cut-off-point of 13 yielded a sensitivity of 92.3% for the category of ‘MinD or MD’, and a specificity of 74.2%. Corresponding values for an adapted cut-off point of 12 are 92.3% and 78.7%, respectively.

The diagnostic accuracy of the WHO-5 in our study is promising. The WHO-5 might be an efficient screening tool for nursing home residents, especially with the adapted cut-off point, but results have to be replicated in a larger sample.