Cross-cultural comparability of the Geriatric Depression Scale

Department of Gerontology, University of South Florida, Tampa 33620, USA.
Aging and Mental Health (Impact Factor: 1.75). 03/2001; 5(1):31-7. DOI: 10.1080/13607860020020618
Source: PubMed


It is becoming increasingly clear that, in order to better understand the implications of global aging, more cross-cultural research is needed. In the present study, the structure and validity of the Geriatric Depression Scale-Short Form (GDS-SF) was examined in Korean and US samples of older adults. The participants included 153 older adults living in Korea (mean age=65.9 years) and 459 older adults from Florida (mean age=72.4 years). All participants completed the original or translated versions of the GDS-SF, as well as additional demographic and health-related measures. The results indicated that the GDS-SF exhibited good reliability in both samples. However, the results of a principal components analysis indicated that the structure was not well replicated across the two samples. In general, the present study suggests that, despite great efforts to make the questionnaires equivalent in the two cultures, the concept of depression for older adults may vary greatly in Korea and the USA. Possible explanations for cross-cultural differences are discussed, as well as implications.

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Available from: William E Haley, Sep 23, 2014
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    • "In the Sleep–EVAL system, questions are mostly answered on scales (frequency, severity or modulated yes/no, for example, rather yes or rather no). As stressed by Noh and Chen (1998) (1992) and Jang et al. (2001), Korean individuals are sensitive to response style. For example, while it is all right for an American or a European to affirm he is happy with his life, it is not socially acceptable to do so for a Korean. "
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    ABSTRACT: Previous epidemiological studies have reported a high prevalence of major depressive disorder (MDD) in North America and Western Europe. However, little information exists on MDD in Asian countries. This study investigates the prevalence of MDD and its characteristics in the general population of South Korea. A representative sample of the South Korean general population composed of 3719 non-institutionalized individuals aged 15 years or older was interviewed by telephone using the Sleep-EVAL system. The participation rate was 91.4%. The interviews covered sociodemographic characteristics, health care utilization, physical illnesses and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) psychiatric disorders. A depressive mood, i.e., feeling sad, downcast, having the blues or having lost interest in things formerly pleasant was reported by 20.9% of the sample without significant difference between men and women and among age groups. DSM-IV MDD was found in 3.6% (95% CI: 3.0-4.2%) of the sample. The prevalence of MDD was comparable among age groups. Shift workers were more likely to have MDD than daytime workers. Factor significantly associated with MDD were: being a woman, being a light or heavy smoker, perceiving one's health as being average or poor, doing physical activities at least three times per week in the evening, having a BMI below 18.5 kg/m2 and perceiving one's life as being moderately or highly stressful. Prevalence of MDD in Korea is higher than what it was previously estimated to be two decades ago. The number of individuals seeking help for depression was very low, and only a small number of MDD subjects received appropriate treatment for their condition.
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    • "These findings indirectly suggest that the factor structure of the SGDS-K is not easily comparable to that of SGDS in Western cultures. This study supports the suggestion of Jang et al. [22] that these results reflect fundamental differences in the way that persons from each culture interpret and respond to questions regarding depressive affect, rather than inadequacies of the translation method. This study has several limitations that concern the treatment of the results concerning the Korean elderly. "
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    ABSTRACT: The aim of this study was to evaluate the diagnostic validity of the Korean version of the Geriatric Depression Scale (GDS-K) and its short form among elderly psychiatric patients. After three preliminary trials, the authors translated the GDS, including the Geriatric Depression Scale-Short Form (SGDS) into Korean. The GDS-K, the Korean version of the SGDS (SGDS-K), Hamilton Rating Scale for Depression (HRS-D), and the Center for Epidemiologic Studies Depression Scale (CES-D) were administered to 154 elderly psychiatric patients. In addition, the Diagnostic Interview Schedule (DIS-III-R) was administered independently to diagnose DSM-III-R major depression. Reliability and validity test, optimal cutoff point estimation, and receiver operating characteristics (ROC) curve analysis were performed to investigate the diagnostic validity of the GDS-K and SGDS-K. Internal consistency-reliability and concurrent validity of the GDS-K and SGDS-K associated with other depression scales (HRS-D, CES-D) were excellent. Content validity and discriminant validity, which differentiate DSM-III-R major depression from nonmajor depression was also good. We suggest a score of 16 as the optimal cutoff point of GDS-K for screening DSM-III-R major depression among clinical populations and a score of 8 as optimal cutoff score of SGDS-K. ROC curve analysis indicated high diagnostic validity for both GDS-K and SGDS-K in assessing DSM-III-R major depression. Moreover, we found that the GDS-K and SGDS-K were highly correlated (r=.9522). This finding suggests that the SGDS-K can be used as an adequate substitute for the GDS-K. The GDS-K and SGDS-K proved valid and reliable case-finding tools for screening DSM-III-R major depression among the elderly psychiatric patients in Korea. The relatively high cutoff points of both the GDS-K and SGDS-K require further evaluation from the viewpoint of culturally determined response style in elderly Koreans.
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