Inpatients with major depressive disorder: Psychometric properties of the new Multidimensional Depression Scale

Measurement invariance of the Multidimensional Depression Assessment Scale (MDAS) across gender and ethnic groups of Asian, Caucasian, Black, and Hispanic

BACKGROUND

Major Depressive Disorder is a severe and highly disabling mental illness. Almost all self-reported questionnaires have overlooked the interpersonal symptoms of depression which are important across gender and culture. The Multidimensional Depression Assessment Scale (MDAS) developed by Cheung and Power (2012) entails comprehensive emotional, cognitive, somatic, and interpersonal subscales. It addresses the criticism that existing self-report depression scales might not cover sufficient phenomenological heterogeneity of depression. The current study aimed to evaluate the psychometric properties of the MDAS across gender and four major ethnic groups of Caucasian, Black, Asian and Hispanic, including reliability and concurrent validity against the Centre for Epidemiological Studies Depression Scale (CESD) and Patients Health Questionnaire (PHQ-9). It also aimed to establish a stable factor structure across gender and ethnic groups and test the measurement invariance to enhance its potential for clinical use.

METHODS

A community sample of 3499 participants from four ethnic groups were recruited via online crowdsourcing sites of Qualtrics and Amazon M Turk. Each individual completed a demographic questionnaire, the MDAS, CESD and PHQ-9.

RESULTS

There was good internal consistency (Cronbach's alpha >0.90) and concurrent reliability across gender and ethnic groups. Strict measurement invariance was established for MDAS over a four-factor factor structure corresponding to the four subscales.

CONCLUSIONS

The MDAS showed good psychometric properties and measurement invariance of a four-factor structure, suggesting its potential to be used in clinical settings across gender and ethnic groups.

LIMITATIONS

Participants all answered the questionnaires in English, which could hinder cultural variations in their expression of symptoms.

The prevalence and odds of depression in patients with vitiligo: a meta-analysis

OBJECTIVE

The objective of this study was to provide a pooled estimate of the prevalence and odds of depression in patients with vitiligo.

METHODS

A systematic literature search of Medline, Embase and Cochrane library databases was conducted. The proportions and mean questionnaire values for depression were pooled according to different evaluation methods. In controlled studies, odds ratio and standardized mean differences compared depression in vitiligo patients with healthy controls.

RESULTS

One thousand nine hundred and sixty-five patients were identified from 20 eligible cohorts to be included in the present meta-analysis review. Sample sizes ranged from 30 to 308 for each analysis. The pooled prevalence of depression across 17 unique populations (n = 1711) was 29% (95% CI 20-39). The prevalence of clinical depression was 8% (95% CI 2%-14%) using Diagnostic and Statistical Manual of Mental Disorders IV or International Classification of Diseases codes-10, and the prevalence of depressive symptoms was 33% (95% CI 23%-44%) using validated screening inventory and rating scales. Patient with vitiligo was 4.96 times more likely to display depression compared with controls. Subgroup analysis showed that the prevalence of depression in Asian and female patients with vitiligo was significantly higher than that in Caucasian and male ones. The pooled prevalence of depressive symptoms was higher (56%, 95% CI 0.5-0.62), and the heterogeneity was lowering cases with Hamilton Depression Rating Scale (HDRS) questionnaire when compared with other questionnaires.

CONCLUSIONS

This meta-analysis review indicates that the prevalence of depression is high in patients with vitiligo. The HDRS questionnaire may be the most sensitive tool for testing the depressive symptoms among patients with vitiligo.