Validation and factor structure of the Thai version of the EURO-D scale for depression among older psychiatric patients
ABSTRACT To assess the concurrent and the construct validity of the Euro-D in older Thai persons.
Eight local psychiatrists used the major depressive episode section of the Mini International Neuropsychiatric Interview to interview 150 consecutive psychiatric clinic attendees. A trained interviewer administered the Euro-D. We used receiver operating characteristic (ROC) analysis to assess the overall discriminability of the Euro-D scale and principal components factor analysis to assess its construct validity.
The area under the ROC curve for the Euro-D with respect to major depressive episode was 0.78 [95% confidence interval (CI) 0.70-0.90] indicating moderately good discriminability. At a cut-point of 5/6 the sensitivity for major depressive episodes is 84.3%, specificity 58.6%, and kappa 0.37 (95% CI 0.22-0.52) indicating fair concordance. However, at the 3/4 cut-point recommended from European studies there is high sensitivity (94%) but poor specificity (34%). The principal components analysis suggested four factors. The first two factors conformed to affective suffering (depression, suicidality and tearfulness) and motivation (interest, concentration and enjoyment). Sleep and appetite constituted a separate factor, whereas pessimism loaded on its own factor.
Among Thai psychiatric clinic attendees Euro-D is moderately valid for major depression. A much higher cut-point may be required than that which is usually advocated. The Thai version also shares two common factors as reported from most of previous studies.
Full-textDOI: · Available from: Melanie Abas, Jun 17, 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)MethodsA 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 2.0Results17,852 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.BMC Psychiatry 02/2015; 15(1):12. DOI:10.1186/s12888-015-0390-4 · 2.24 Impact Factor
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ABSTRACT: Depression is among the most common psychiatric conditions in primary health care, and constitutes an important part of the global disease burden. However, it is difficult to obtain comparable data on depression worldwide and models for treatment and intervention need to be locally adapted. We conducted a narrative review of research literature on factors that influence depression screening, diagnosis and treatment among the Vietnamese population. This explorative approach included studies describing: a) culturally or contextually specific risk-factors for depression; b) any depression treatment seeking or treatment acceptability/adherence aspects or; c) depression screening among Vietnamese patients. We searched the PubMed and Cinahl databases, as well as relevant Vietnamese peer-reviewed journals and this produced 20 articles that were included in the review. Our findings indicate the importance of considering somatic symptoms when screening for depression in Vietnam as well as the use of culturally adapted and dimensional screening instruments. Our study confirms that depression reflects chronic social adversity, and thus an approach to mental health management that focuses solely on individual pathology will fail to address its important social causes. Further studies should elucidate whether neurasthenia is a commonly used illness label among Vietnamese patients that coincides with depression. The tendency among Vietnamese to seek traditional Vietnamese medicine and meditation practice when experiencing emotional distress was supported by our findings.International Journal of Mental Health Systems 05/2013; 7(1):15. DOI:10.1186/1752-4458-7-15 · 1.06 Impact Factor
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ABSTRACT: Global population is ageing and Thailand has one of the fastest growing ageing populations in this region. Combined with this, depression has become a major mental health problem for older people. The objective of this paper is to examine the predictors of depression among rural older people of Thailand. This study has used information from the Study on Health and Social Support among Older Population living in Kanchanaburi Demographic Surveillance System (KDSS), Thailand in 2006. Depression was measured by a 12 item questionnaire of Thai validated Euro-D scale among 1001 respondents. The questions were on depression, pessimism, wishing to die, guilt, sleep disturbance, loss of interest, irritability, eating problems, fatigue, problem in concentration, lack of enjoyment, and tearfulness. Among the respondents 28.5% had depression. The results of logistic regression found that infirmity, disability and serious life events had significant effect on depression of the respondent. Those who had 4 or more infirmity, they were 2.08 times more likely to have depression compare to those who had no or only 1 infirmity. Disability was another strong predictor of the depression. It should be mentioned here that those who had medium disability, had the chance of depression 3.12 times more compare to those who had no disability. Serious life event was also a major factor for the respondents. Those who had 3 or more serious life events they had the depression 5.25 times more compare to those who had no serious life event.This study identified three major predictors of depression for older people in KDSS, Thailand. The finding will help to design specific prevention program to reduce the depression of older people living in the rural area of Thailand.Bangladesh Medical Research Council Bulletin 08/2011; 37(2):51-6. DOI:10.3329/bmrcb.v37i2.8434