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BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Psychometric properties of EURO-D, a geriatric depression scale: a cross-cultural validation study

Authors: Mariella Guerra, Cleusa Ferri, Juan Llibre, A Matthew Prina, Martin Prince

Published in: BMC Psychiatry | Issue 1/2015

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Abstract

Background

Many of the assessment tools used to study depression among older people are adaptations of instruments developed in other cultural setting. There is a need to validate those instruments in low and middle income countries (LMIC).

Methods

A one-phase cross-sectional survey of people aged [greater than or equal to] 65 years from LMIC. EURO-D was checked for psychometric properties. Calibration with clinical diagnosis was made using ICD-10. Optimal cutpoint was determined. Concurrent validity was assessed measuring correlations with WHODAS 2.0.

Results

17,852 interviews were completed in 13 sites from nine countries. EURO-D constituted a hierarchical scale in most sites. The most commonly endorsed symptom in Latin American sites was depression; in China was sleep disturbance and tearfulness; in India, irritability and fatigue and in Nigeria loss of enjoyment. Two factor structure (affective and motivation) were demonstrated. Measurement invariance was demonstrated among Latin American and Indian sites being less evident in China and Nigeria. At the 4/5 cutpoint, sensitivity for ICD-10 depressive episode was 86% or higher in all sites and specificity exceeded 84% in all Latin America and Chinese sites. Concurrent validity was supported, at least for Latin American and Indian sites.

Conclusions

There is evidence for the cross-cultural validity of the EURO-D scale at Latin American and Indian settings and its potential applicability in comparative epidemiological studies.
Literature
1.
Mulsant BH, Ganguli M. Epidemiology and diagnosis of depression in late life. J Clin Psychiatry. 1999;60 Suppl 20:29–15.
2.
Beekman ATF, Deeg DJH, van Tilburg T, Smit JH, Hooijer C, van Tilburg W. Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord. 1995;36:65–75.CrossRefPubMed
3.
Blazer D. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58(3):249–65.CrossRefPubMed
4.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders FE, (DSM - 5). Washington, DC: APA; 2013.CrossRef
5.
World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders. Diagnostic Criteria for Research. Geneva: WHO; 1992.
6.
Gallo JJ, Rabins PV, Lyketsos CG, Tien AY, Anthony JC. Depression without sadness: functional outcomes of nondysphoric depression in later life. J Am Geriatr Soc. 1997;45(5):570–8.CrossRefPubMed
7.
Gallo JJ, Rabins PV, Anthony JC. Sadness in older persons: 13-year follow-up of a community sample in Baltimore. Maryland Psychol Med. 1999;29:341–50.CrossRefPubMed
8.
Adams KB. Depressive symptoms, depletion or developmental change? Withdrawal, apathy, and lack of vigor in the geriatric depression scale. Gerontologist. 2001;41(6):768–77.CrossRefPubMed
9.
10.
Yesavage JA, Brink TL. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49.CrossRefPubMed
11.
Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. In: Clinical Gerontology: A Guide to Assessment and Intervention. NY: The Haworth Press; 1986. p. 165–73.
12.
Prince MJ, Reischies F, Beekman ATF, Fuhrer C, Jonker SL, Kivela BA, et al. Development of the EURO-D scale–a European, Union initiative to compare symptoms of depression in 14 European centres. Br J Psychiatry. 1999;174:330–8.CrossRefPubMed
13.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.CrossRef
14.
Goldberg D, Williams P. A Users Guide to the General Health Questionnaire. Windsor: NEFER, Nelson; 1988.
15.
16.
Wu W, Zhang MY. Application of depression scale CES-D among the elderly people in the community. Shangai Shangai Arch Psychiatry. 1989;7(3):139–42.
17.
Meng C, Tang Z. Analysis and comparison urban and rural elderly depressive symptoms in Beijing. Chin J Gerontol. 2000;20(4):196–9.
18.
Pan A, Franco OH, Wan Y, Yu Z, Ye X, Lin X. Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China. J Affect Disord. 2008;105:167–75.CrossRefPubMed
19.
Zunzunegui MV, Alvarado BE, Beland F, Vissandjee B. Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med. 2009;68(2):235–42.CrossRefPubMed
20.
Alvarado BE, Zunzunegui MV, Beland F, Sicotte M, Tellechea L. Social and gender inequalities in depressive symptoms among urban older adults of latin america and the Caribbean. J Gerontol B Psychol Sci Soc Sci. 2007;62B(4):S226–36.CrossRef
21.
Chi I,DSW, Yip P, Chiu H, Chou KL, Chan KS, Kwan CW, et al. Prevalence of depression and its correlates in Hong Kong's Chinese older adults. Am J Geriatr Psychiatry. 2005;13(5):409–16.CrossRefPubMed
22.
Castro Costa E, Dewey M, Stewart R, Banerjee S, Huppert F, Mendonca-Lima C, et al. Ascertaining late-life depressive symptoms in Europe: an evaluation of the EURO-D scale in10 nations.The SHARE project. Int J Methods Psychiatr Res. 2008;17(1):12–29.CrossRefPubMed
23.
Prince M, Ferri C, Acosta D, Albanese E, Arizaga R, Dewey M, et al. The protocols for the 10/66 dementia research group population-based research programme. BMC Public Health. 2007;7:165.CrossRefPubMedPubMedCentral
24.
Prince M, Acosta D, Chiu H, Scazufca M, Varghese M. Dementia diagnosis in developing countries: a cross-cultural validation study. Lancet. 2003;361:909–17.CrossRefPubMed
25.
Giyeon K, Jamie DC, Chao Hui H, Bryant AN. A meta-analysis of the factor structure of the geriatric depression scale (GDS): the effects of language. Int Psychogeriatr. 2013;25(1):71–81.CrossRef
26.
Copeland JRM, Prince M, Wilson KCM, Dewey ME, Payne J, Gurland B. The geriatric mental state examination in the 21st century. Int J Geriatr Psychiatry. 2002;17(8):729–32.CrossRefPubMed
27.
Copeland JRM, Kelleher MJ, Kellett JM, Gourlay AJ, Gurland BJ, Fleiss JL, et al. A semi-structured clinical interview foar the assessment of diagnosis and mental state in the elderly: the geriatric mental state schedule: I. Development and reliability. Psychol Med. 1976;6(3):439–49.CrossRefPubMed
28.
Copeland JRM, Dewey ME, Henderson AS, Kay DWK, Neal CD, Harrison MAM, et al. The Geriatric Mental State (GMS) used in the community: replication studies of the computerized diagnosis AGECAT. Psychol Med. 1988;18(1):219–23.CrossRefPubMed
29.
Livingston G, Sax K, Willison J, Blizard B, Mann A. The Gospel Oak Study stage II: the diagnosis of dementia in the community. Psychol Med. 1990;20(4):881–91.CrossRefPubMed
30.
Collighan G, Macdonald A, Herzberg J, Philpot M, Lindesay J. An evaluation of the multidisciplinary approach to psychiatric diagnosis in elderly people. BMJ. 1993;306(6881):821–4.CrossRefPubMedPubMedCentral
31.
Copeland JRM, Dewey ME, Griffiths Jones HM. A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychol Med. 1986;16(1):89–99.CrossRefPubMed
32.
Castro-Costa E, Dewey M, Stewart R, Banerjee S, Huppert F, Mendonca-Lima C, et al. Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study. Br J Psychiatry. 2007;191:393–401.CrossRefPubMed
33.
Ustun T, Kostanjsek N, Chatterji S, Rehm J. Measuring health and disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva: World Health Organization; 2010.
34.
Sousa RM, Dewey ME, Acosta D, Sousa RM, Dewey ME, Acosta D, et al. Measuring disability across cultures--the psychometric properties of the WHODAS II in older people from seven low- and middle-income countries. The 10/66 Dementia Research Group population-based survey. Int J Methods Psychiatr Res. 2010;19(1):1–17.PubMedPubMedCentral
35.
Mokken R. A Theory and Procedure of Scale Analysis. Berlin, Germany: De Gruyter; 1971.CrossRef
36.
Dijkstra A, Buist G, Moorer P, Dassen T. Construct validity of the nursing care dependency scale. J Clin Nurs. 1999;8(4):380–8.CrossRefPubMed
37.
Sijtsma K, Emons WHM, Bouwmeester S, Nyklicek I, Roorda LD. Nonparametric IRT analysis of quality of life scales and its application to the World Health Organization Quality of Life Scale. Qual Life Res. 2008;17(2):275–90.CrossRefPubMedPubMedCentral
38.
Van der Ark LA. Mokken scale analysis in R. J Stat Softw. 2007;20(11):1–19.CrossRef
39.
Molenaar IW, Sijtsma K. MPS5 for Windows. A program for Mokken scale analysis for polytomous items. 2000.
40.
41.
Tucker L. A reliability coefficient for maximum likelihood factor analysis. Psychometrika. 1973;38:1–10.CrossRef
42.
Burnham KP, Anderson DR. Multimodel Inference: understanding AIC and BIC in model selection. Sociol Methods Res. 2004;33(2):261–304.CrossRef
43.
Dunn G, Everitt B, Pickles. Modelling Covariances and Latent Variables using EQS. 1st ed. London: Chapman & Hall; 1993.
44.
Marsh HW, Balla JR, Jau KT. An evaluation of incremental fit indices : a clarification of mathematical and empiracal properties. In: Advanced Structural Equation Modelling: Issues and Techniques, vol. 11. 1996. p. 315–55.
45.
Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol Methods Res. 1992;21:230–58.CrossRef
46.
Prince MJ, Beekman AT, Deeg DJ, Fuhrer R, Kivela SL, Lawlor BA, et al. Depression symptoms in late life assessed using the EURO-D scale. Effect of age, gender and marital status in 14 European centres. Br J Psychiatry. 1999;174:339–45.CrossRefPubMed
47.
Copeland JR, Beekman ATF, Braam AW, Deway ME, Delespau P, Fuhrer R, et al. Depression among older people in Europe. The EURODEP studies. World Psychiatry. 2004;3(1):45–9.PubMedPubMedCentral
48.
Larraga L, Saz P, Dewey ME, Marcos G, Lobo A, ZARADEMP Workgroup. Validation of the Spanish version of the EURO-D scale: an instrument for detecting depression in older people. Int J Geriatr Psychiatry. 2006;21(12):1199–205.CrossRefPubMed
49.
Braam AW, Prince MJ, Beekman AT, Delespaul P, Dewey ME, Geerlings S, et al. Physical health and depressive symptoms in older Europeans. Results from EURODEP. Br J Psychiatry. 2005;187:35–42.CrossRefPubMed
50.
Barry L, Allore HG, Bruce ML, Gill TM. Longitudinal association between depressive symptoms and disability burden among older persons. J Gerontol A Biol Sci Med Sci. 2009;64A(12):1325–32.CrossRefPubMedCentral
51.
52.
Layard R, Chisholm, D, Patel, V, Saxena S. ‘Mental illness and unhappiness’ in Helliwell J.F., Layard,R. and Sachs, J. (eds), World Happiness Report 2013.New York: Sustainable Development Solutions Network; 2013a.38-53
53.
Lee S. Diagnosis postponed: Shenjing Shuairuo and the transformation of psychiatry in Post-Mao China. Cult Med Psychiatry. 1999;23:349–80.CrossRefPubMed
54.
Wong D, Xuesong H, Poon A, Lam AY. Depression literacy among Chinese in Shanghai, China: a comparison with Chinese-speaking Australians in Melbourne and Chinese in Hong Kong. Soc Psychiatry Psychiatr Epidemiol. 2012;47(8):1235–42.CrossRefPubMed
55.
Jirapramukpitak TN, Darawuttimaprakorn Punpuing S, Abas M. Validation and factor structure of the Thai version of the EURO-D scale for depression among older psychiatric patients. Aging Mental Health. 2009;13(6):899–904.CrossRefPubMedPubMedCentral
56.
Ola BA, Morakinyo O, Adewuya AO. Brain Fag syndrome - a myth or a reality. Aff J Psychiatry (Johannesbg). 2009;12(2):135–43.
Metadata
Title
Psychometric properties of EURO-D, a geriatric depression scale: a cross-cultural validation study
Authors
Mariella Guerra
Cleusa Ferri
Juan Llibre
A Matthew Prina
Martin Prince
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0390-4

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