A measure of depression in a modern asian community: singapore

Assigning Clinical Significance and Symptom Severity Using the Zung Scales: Levels of Misclassification Arising from Confusion between Index and Raw Scores

BACKGROUND

The Zung Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) are two norm-referenced scales commonly used to identify the presence of depression and anxiety in clinical research. Unfortunately, several researchers have mistakenly applied index score criteria to raw scores when assigning clinical significance and symptom severity ratings. This study examined the extent of this problem.

METHOD

102 papers published over the six-year period from 2010 to 2015 were used to establish two convenience samples of 60 usages of each Zung scale.

RESULTS

In those papers where cut-off scores were used (i.e., 45/60 for SDS and 40/60 for SAS), up to 51% of SDS and 45% of SAS papers involved the incorrect application of index score criteria to raw scores. Inconsistencies were also noted in the severity ranges and cut-off scores used.

CONCLUSIONS

A large percentage of publications involving the Zung SDS and SAS scales are using incorrect criteria for the classification of clinically significant symptoms of depression and anxiety. The most common error-applying index score criteria to raw scores-produces a substantial elevation of the cut-off points for significance. Given the continuing usage of these scales, it is important that these inconsistencies be highlighted and resolved.

Effects of horticultural therapy on elderly' health: protocol of a randomized controlled trial

BACKGROUND

Due to a rapidly ageing population in the world, it is increasingly pertinent to promote successful ageing strategies which are cost-effective, easily accessible, and more likely to be acceptable to the elderly. Past research associates exposure to natural environments and horticultural therapy (HT) with positive psychological, social and physical health benefits. This Randomized Controlled Trial (RCT) is designed to evaluate the efficacy of HT in promoting Asian elderly' mental health, cognitive functioning and physical health.

METHODS/DESIGN

70 elderly participants aged 60 to 85 years old will be randomized to participate in either the active horticultural therapy group or be in the waitlist control. Sessions will be weekly for 12 weeks, and monthly for 3 months. Mental health will be assessed through self-reports of depressive and anxiety symptomatology, life satisfaction, social connectedness and psychological well-being, collaborated with immunological markers. Outcome measures of cognitive functioning and physical health include neuropsychological tests of cognitive function and basic health screening. Outcomes will be assessed at baseline, 3 months and 6 months post-intervention.

DISCUSSION

This RCT comprehensively investigates the efficacy of a non-invasive intervention, HT, in enhancing mental health, cognitive functioning and physical health. The results have tremendous potential for supporting future successful ageing programs and applicability to larger populations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02495194 . Trial registration date: July 13, 2015. Retrospectively registered.

Effectiveness of taking in the good based-bibliotherapy intervention program among depressed Filipino female adolescents

Adolescent depression is a severe mental health problem. Philippines has the highest incidence of depression in South East Asia. Depressed female adolescents habitually seek and retain negative experiences. Aim of this research was to develop and to assess effectiveness of a Taking in the Good Based-Bibliotherapy Intervention Program for female adolescents. As an innovative type of psychotherapy treatment, program aimed to build up their inner strengths by experiencing, enriching and absorbing daily events with a positive attitude and installing them in brain. Program was conducted in two phases: 1. Development of taking in the good based-bibliotherapy intervention. 2. Implementation and assessment of pioneering treatment for alleviating depression and thereby increasing positive cognitive appraisal by employing true experimental research design particularly between subjects. Beck Depression Inventory-II, Asian Adolescent Depression Scale and Kutcher Adolescent Depression Scale-11 were administered before and after implementation of the program. A total of 30 female adolescents, Filipino High School students, (mean age=13.9), were randomly assigned to experimental (n=15) and control (n=15) conditions. Data analysis was done by employing percentage and frequency distribution, mean scores, standard deviation, dependent t-test, independent t-test statistics and Cohen's d. The null hypothesis was tested at the 0.05 level of significance. Statistical analysis between the pre-test and post-test scores of the experimental group showed significant difference (p=0.000) and scores of control and experimental group showed significant difference (p=0.000) in all dependent variables in the post-test. These results revealed that "Taking in the Good based-Bibliotherapy Intervention" was effective in reducing depression in female adolescents.