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Zare H, Ibe CA, Yang M, Porter G, Gaston M, Jones N, Jones W, Rose V, Balamani M, Woods DL, Gaskin DJ. Evaluating the Impact of the Prime Time Sister Circles ® Intervention on Reducing Depressive Symptoms Among African American Women with Uncontrolled Hypertension. J Gen Intern Med 2023; 38:2879-2887. [PMID: 37500950 PMCID: PMC10593703 DOI: 10.1007/s11606-023-08288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/15/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The Prime Time Sister Circles®, a randomized controlled trial (PTSC-RCT), assessed the impact of a community-based peer support program on hypertension management among African American women 40-75 years of age. While the PTSC-RCT was designed to evaluate changes in blood pressure control, subsequent sub-analyses revealed a high proportion of self-reported depressive symptoms in our sample. Accordingly, we conducted an ancillary investigation of the PTSC intervention on depression to ascertain its impact on reduced depressive symptoms in the study population. METHOD Depressive symptoms were measured using an adapted version of the Center for Epidemiologic Studies Depression Scale Revised (CES-D-10). We used unadjusted and adjusted fixed effect models. Data for this study came from the PTSC-RCT. We collected data between 2017 and 2018 in Washington, DC. We used a balanced analytical sample of 172 African American, English-speaking women between 40 to 75 years old with uncontrolled hypertension. INTERVENTION The intervention group participated in a 2-h, peer-based support group once a week for 13 weeks. A trained PTSC facilitator facilitated sessions with experts who delivered content on various topics, including psychosocial wellness (e.g., stress, depressive symptoms, anxiety management, and self-esteem), physical health (e.g., hypertension, inflammation, and heart disease), physical activity, and healthy nutrition. RESULTS Results from the fixed-effects models indicated that participants in the PTSC program exhibited a greater reduction in CES-D-10 score at three months (Coeff: -1.99, 95% CI: -3.49, -0.49) and at 15 months (Coeff: -2.38, 95% CI: -3.94, -0.83), as compared to those in the control group. CONCLUSIONS Evidence suggests that the Prime Time Sister Circles® intervention reduced depressive symptoms among African American women with low socioeconomic status and hypertension. TRIAL REGISTRATION NCT04371614.
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Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- University of Maryland Global Campus (UMGC), Adelphi, USA.
| | - Chidinma A Ibe
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Gayle Porter
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
| | - Marilyn Gaston
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
| | - Nicole Jones
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wehmah Jones
- American Institutes for Research, Washington, DC, USA
| | - Vivienne Rose
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michele Balamani
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
- Baraka and Associates, Largo, MD, USA
| | - Denise L Woods
- The Gaston & Porter Health Improvement Center, Inc, Washington, DC, USA
| | - Darrell J Gaskin
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Nerobkova N, Park YS, Park EC, Shin J. Frailty transition and depression among community-dwelling older adults: the Korean Longitudinal Study of Aging (2006-2020). BMC Geriatr 2023; 23:148. [PMID: 36932383 PMCID: PMC10024357 DOI: 10.1186/s12877-022-03570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/10/2022] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Frailty is recognized as a geriatric syndrome associated with depression. The consequences and mechanism of frailty transitions are still understudied. This study assessed the influence of frailty transitions on new-onset depressive symptomology using longitudinal, nationwide data of Korean community-dwelling older adults. METHODS Longitudinal population-based study conducted in every even-numbered year starting from 2006 to 2020 (eight waves) with a sample of older adults aged ≥ 60 years old. After the application of exclusion criteria, a total of 2,256 participants were included in the 2008 baseline year. Frailty transition was determined through the biennial assessment of change in frailty status using the frailty instrument (FI); depression was measured using the Center for Epidemiological Studies Depression 10 Scale. We employed the lagged general estimating equations to assess the temporal effect of frailty transition on obtaining depressive symptoms. RESULTS Compared to non-frail individuals, the risk of depression was higher in transitioned into frailty and constantly frail participants over a 2-year interval: men (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.21-1.32; OR 1.29, 95% CI 1.21-1.38), women (OR 1.34, 95% CI 1.28-1.40; OR 1.51, 95% CI 1.41-1.62), respectively. CONCLUSIONS Frailty transition is found to be associated with new-onset depressive symptoms. Frail individuals and those who transitioned into frailty were associated with a higher risk of depression. Particular attention should be paid to these frailty transitioned groups. Early intervention and implementation of prevention strategies at physical, nutritional, and social levels are warranted to ameliorate frailty and depression in late life.
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Affiliation(s)
- Nataliya Nerobkova
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-to, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Department of Policy Analysis and Management, College of Human Ecology, Cornell University, Ithaca, NY, USA.
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Ho S, Mersch J, Martin WB, Howe-Martin L. Exploring Depressive Symptoms and Cancer Worries in a High-Volume Cancer Genetics Clinic: What Are the Roles of Age and Cancer Diagnosis? J Adolesc Young Adult Oncol 2022. [PMID: 35960502 DOI: 10.1089/jayao.2022.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Limited research has explored depression and cancer worries (CWs) among adolescents and young adults with cancer (AYAs) seeking genetic counseling. This study evaluated depressive symptoms and CWs among five groups: AYAs, adolescents and young adults without cancer (AYAWOCs), older adults with cancer (OAs), older adults without cancer (OAWOCs), and older adults diagnosed with cancer in their adolescent and young adult years (OA/AYAs). A retrospective data analysis was performed on 6524 patients, which found that AYAs reported significantly higher depressive symptoms and CWs compared with all other groups except OA/AYAs. These findings suggest that the intersection between age and cancer diagnosis is related to depressive symptoms and CWs.
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Affiliation(s)
- Sally Ho
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
| | - Jacqueline Mersch
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.,Cancer Genetics Program, UT Southwestern Medical Center, Dallas, Texas, USA
| | - W Blake Martin
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Laura Howe-Martin
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
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Sileo KM, Wanyenze RK, Schmarje Crockett K, Naigino R, Ediau M, Lule H, Kalichman SC, Lin CD, Menzies N, Bateganya MH, Kiene SM. Prevalence and correlates of depressive symptoms, and points of intervention, in rural central Uganda: results from a cross-sectional population-based survey of women and men. BMJ Open 2022; 12:e054936. [PMID: 35641013 PMCID: PMC9157366 DOI: 10.1136/bmjopen-2021-054936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The present study aimed to identify the prevalence and correlates of depressive symptoms and potential intervention points among women and men from a population-based sample in rural central Uganda. DESIGN A cross-sectional study. SETTING Four districts in rural Uganda. PARTICIPANTS Women and men aged 15-59 residing in four districts in rural Uganda accepting home-based HIV testing who completed a baseline survey at the time of testing. PRIMARY OUTCOME MEASURES Depressive symptoms measured by the 10-item Center for Epidemiological Studies Depression Scale using a cut-off score of 13 for significant depressive symptoms. RESULTS Among a sample of 9609 women and 6059 men, 1415 (14.7%) women and 727 (12.0%) men met criteria for significant depressive symptoms. Having ever received mental health services was associated with lower odds of significant depressive symptoms (women: adjusted OR (adjOR)=0.32, 95% CI=0.22 to 0.47; men: adjOR=0.36, 95% CI=0.18 to 0.62). Having received outpatient (women: adjOR=3.64, 95% CI=3.14 to 4.22; men: adjOR=3.37, 95% CI=2.78 to 4.07) or inpatient (women: adjOR=5.44, 95% CI=4.24 to 6.97; men: adjOR=3.42, 95% CI=2.21 to 5.28) care in the prior 6 months was associated with greater odds of significant depressive symptoms. For women only, known HIV positive status (adjOR=1.37, 95% CI=1.05 to 1.77), and for men only, alcohol misuse (adjOR=1.38, 95% CI=1.12 to 1.70), were associated with increased odds of significant depressive symptoms. CONCLUSION Our findings suggest that depression screening within outpatient and inpatient settings may help to identify people in need of mental health services. Routine screening in outpatient or inpatient clinics along with the implementation of evidence-based interventions could ultimately help close the mental health gap for depression in this and similar settings.
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Affiliation(s)
- Katelyn M Sileo
- Department of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Rhoda K Wanyenze
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
| | - Katherine Schmarje Crockett
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Rose Naigino
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Michael Ediau
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Haruna Lule
- Division of Health Systems Strengthening, Global Centre of Excellence in Health (GLoCEH), Kampala, Uganda
| | - Seth C Kalichman
- Institute for Collaboration on Health, Intervention and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Chii-Dean Lin
- Department of Mathematics and Statistics, San Diego State University, San Diego, California, USA
| | - Nicolas Menzies
- Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Moses H Bateganya
- Infectious Diseases and Health Systems, FHI 360, Durham, North Carolina, USA
| | - Susan M Kiene
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA
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Mohebbi M, Agustini B, Woods RL, McNeil JJ, Nelson MR, Shah RC, Nguyen V, Storey E, Murray AM, Reid CM, Kirpach B, Wolfe R, Lockery JE, Berk M. Prevalence of depressive symptoms and its associated factors among healthy community-dwelling older adults living in Australia and the United States. Int J Geriatr Psychiatry 2019; 34:1208-1216. [PMID: 30989707 PMCID: PMC6924573 DOI: 10.1002/gps.5119] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 04/08/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study was conducted to estimate prevalence rates and factors associated with depressive symptoms indexed by the Centre for Epidemiological Studies-Depression (CES-D-10) score in a large sample of community-dwelling healthy older adults from Australia and the United States. Convergent and divergent validity of the CES-D-10 were also examined. METHODS A total of 19 114 individuals aged greater than or equal to 65 years old were enrolled from a primary prevention clinical trial. Depressive symptoms were classified using the CES-D-10 score greater than or equal to 8 and greater than or equal to 10. Gender-specific prevalence for subgroups according to sociodemographic characteristics were reported, and factors associated with depressive symptoms were estimated. RESULTS The overall prevalence rates of depressive symptoms were 9.8%, 95% CI, 8.5-11.2 and 5.0%, 95% CI, 4.0-6.0, according to the CES-D-10 score greater than or equal to 8 and greater than or equal to 10, respectively. Depressive symptoms were more common in women, individuals with less than 12 years of education, those living alone or in a residential care, ethnic minorities, current smokers, and former alcohol users. Convergent and divergent validities of the CES-D-10 were confirmed by observing strong negative association with the SF-12 mental health component and a modest negative association with SF-12 physical component, respectively. CONCLUSIONS This study reports the prevalence of depressive symptoms in Australian and US community-dwelling healthy older populations. These findings emphasize the high burden of the condition and factors associated with depressive symptoms, to better inform clinicians and help with early detection and treatment of depression in this age group.
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Affiliation(s)
- Mohammadreza Mohebbi
- Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
- School of Medicine, IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia
| | - Bruno Agustini
- School of Medicine, IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Van Nguyen
- Biostatistics Unit, Deakin University, Geelong, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia
| | - Elsdon Storey
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin County Medical Center, Minneapolis, MN, USA
- Division of Geriatrics, Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN, USA
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Brenda Kirpach
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica E Lockery
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael Berk
- School of Medicine, IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Orygen, the National Centre of Excellence in Youth Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
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Mohebbi M, Nguyen V, McNeil JJ, Woods RL, Nelson MR, Shah RC, Storey E, Murray AM, Reid CM, Kirpach B, Wolfe R, Lockery JE, Berk M. Psychometric properties of a short form of the Center for Epidemiologic Studies Depression ( CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults. Gen Hosp Psychiatry 2018; 51:118-125. [PMID: 28890280 PMCID: PMC6178798 DOI: 10.1016/j.genhosppsych.2017.08.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D-10) is a widely used self-report measure of depression symptomatology. The aim of this study is to investigate the psychometric properties of the CES-D-10 in healthy community dwelling older adults. METHODS The sample consists of 19,114 community-based individuals residing in Australia and the United States who participated in the ASPREE trial baseline assessment. All individuals were free of any major illness at the time. We evaluated construct validity by performing confirmatory factor analysis, examined measurement invariance across country and gender followed by evaluating item discrimination bias in age, gender, race, ethnicity and education level, and assessing internal consistency. RESULTS High item-total correlations and Cronbach's alpha indicated high internal consistency. The factor analyses suggested a unidimensional factor structure. Construct validity was supported in the overall sample, and by country and gender sub-groups. The CES-D-10 was invariant across countries, and although evidence of marginal gender non-invariance was observed there was no evidence of notable gender specific item discrimination bias. No notable differences in discrimination parameters or group membership measurement non-invariance were detected by gender, age, race, ethnicity, and education level. CONCLUSION These findings suggest the CES-D-10 is a reliable and valid measure of depression in a volunteer sample. No noteworthy evidence of invariance and/or item discrimination bias is observed across gender, age, race, language and ethnic groups.
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Affiliation(s)
- Mohammadreza Mohebbi
- Deakin University, Biostatistics Unit, Geelong, Australia; Deakin University, School of Medicine, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australia.
| | - Van Nguyen
- Deakin University, Biostatistics Unit, Geelong, Australia,Deakin University, School of Nursing and Midwifery, Geelong, Australia
| | - John J. McNeil
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L. Woods
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Elsdon Storey
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin County Medical Center, Minneapolis, MN, United States,Division of Geriatrics, Department of Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN, United States
| | - Christopher M. Reid
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia,School of Public Health, Curtin University, Perth, WA, Australia
| | - Brenda Kirpach
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin County Medical Center, Minneapolis, MN, United States
| | - Rory Wolfe
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jessica E. Lockery
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australi,Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia,Orygen, the National Centre of Excellence in Youth Health, the Department of Psychiatry and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia
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Baron EC, Davies T, Lund C. Validation of the 10-item Centre for Epidemiological Studies Depression Scale ( CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. BMC Psychiatry 2017; 17:6. [PMID: 28068955 PMCID: PMC5223549 DOI: 10.1186/s12888-016-1178-x] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 12/24/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) is a depression screening tool that has been used in the South African National Income Dynamics Study (NIDS), a national household panel study. This screening tool has not yet been validated in South Africa. This study aimed to establish the reliability and validity of the CES-D-10 in Zulu, Xhosa and Afrikaans. The CES-D-10's psychometric properties were also compared to the Patient Health Questionnaire (PHQ-9), a depression screening tool already validated in South Africa. METHODS Stratified random samples of Xhosa, Afrikaans and Zulu-speaking participants aged 15 years or older (N = 944) were recruited from Cape Town Metro and Ethekwini districts. Face-to-face interviews included socio-demographic questions, the CES-D-10, Patient Health Questionnaire (PHQ-9), and WHO Disability Assessment Schedule 2.0 (WHODAS). Major depression was determined using the Mini International Neuropsychiatric Interview. All instruments were translated and back-translated to English. Construct validity was examined using exploratory factor analysis with varimax rotation. Receiver Operating Characteristics (ROC) curves were used to investigate the CES-D-10 and PHQ-9's criterion validity, and compared using the DeLong method. RESULTS Overall, 6.6, 18.0 and 6.9% of the Zulu, Afrikaans and Xhosa samples were diagnosed with depression, respectively. The CES-D-10 had acceptable internal consistency across samples (α = 0.69-0.89), and adequate concurrent validity, when compared to the PHQ-9 and WHODAS. The CES-D-10 area under the Receiver Operator Characteristic curve was good to excellent: 0.81 (95% CI 0.71-0.90) for Zulu, 0.93 (95% CI 0.90-0.96) for Afrikaans, and 0.94 (95% CI 0.89-0.99) for Xhosa. A cut-off of 12, 11 and 13 for Zulu, Afrikaans and Xhosa, respectively, generated the most balanced sensitivity, specificity and positive predictive value (Zulu: 71.4, 72.6% and 16.1%; Afrikaans: 84.6%, 84.0%, 53.7%; Xhosa: 81.0%, 95.0%, 54.8%). These were slightly higher than those generated for the PHQ-9. The CES-D-10 and PHQ-9 otherwise performed similarly across samples. CONCLUSIONS The CES-D-10 is a valid, reliable screening tool for depression in Zulu, Xhosa and coloured Afrikaans populations.
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Affiliation(s)
- Emily Claire Baron
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Office 32, Building B, 46 Sawkins Road, 7700 Rondebosch, Cape Town, South Africa.
| | - Thandi Davies
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Office 32, Building B, 46 Sawkins Road, 7700 Rondebosch, Cape Town, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Office 32, Building B, 46 Sawkins Road, 7700 Rondebosch, Cape Town, South Africa ,Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Abstract
The 10-item Center for the Epidemiological Studies of Depression Short Form (CES-D-10) is a widely used measure to screen for depression in primary care settings. The 10-item measure has demonstrated strong psychometric properties, including predictive accuracy and high correlations with the original 20-item version, in community populations. However, clinical utility and psychometric properties have yet to be assessed in an acutely symptomatic psychiatric population. This study examined the psychometric properties of the CES-D-10 in a sample of 755 patients enrolled in a psychiatric partial hospital program. Participants completed a diagnostic interview and a battery of self-report measures on admission and discharge. Exploratory factor analysis and confirmatory factor analysis suggested that a one-factor structure provided a good fit to the data. High item-total correlations indicated high internal consistency, and the CES-D-10 demonstrated both convergent validity and divergent validity. Previously suggested cutoff scores of 8 and 10 resulted in good sensitivity (.91 and .89, respectively) but poor specificity (.35 and .47). These data suggest that although the CES-D-10 has generally strong psychometric properties in this psychiatric sample, the measure should be primarily used to assess depression symptom severity rather than as a diagnostic screening tool.
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