Development of the EURO-D Scale – A European, Union Initiative to Compare Symptoms of Depression in 14 European Centers

Department of Psychiatry, VU University Amsterdam, Amsterdamo, North Holland, Netherlands
The British Journal of Psychiatry (Impact Factor: 7.99). 05/1999; 174(4):330-8. DOI: 10.1192/bjp.174.4.330
Source: PubMed


In an 11-country European collaboration, 14 population-based surveys included 21,724 subjects aged > or = 65 years. Most participating centres used the Geriatric Mental State (GMS), but other measures were also used.
To derive from these instruments a common depression symptoms scale, the EURO-D, to allow comparison of risk factor profiles between centres.
Common items were identified from the instruments. Algorithms for fitting items to GMS were derived by observation of item correspondence or expert opinion. The resulting 12-item scale was checked for internal consistency, criterion validity and uniformity of factor-analytic profile.
The EURO-D is internally consistent, capturing the essence of its parent instrument. A two-factor solution seemed appropriate: depression, tearfulness and wishing to die loaded on the first factor (affective suffering), and loss of interest, poor concentration and lack of enjoyment on the second (motivation).
The EURO-D scale should permit valid comparison of risk-factor associations between centres, even if between-centre variation remains difficult to attribute.

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Available from: Brian A Lawlor, Dec 20, 2013
    • "Every domain is scored 1 point if present, and 0 points if absent, and total score is the sum of all the items, leading to a minimum score of 0 and a maximum score of 12. The optimal cut-off point of this scale was set to 4 points or above for a clinically significant depression (Prince et al., 1999). "
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    ABSTRACT: Background The longitudinal association of depression and pain according to gender was investigated using a population-based sample from 13 European countries. Methods The study population was taken from waves 4-5 of the Survey of Health, Ageing and Retirement in Europe. The sample consisted of 22,280 participants ≥50 years, who were interviewed at baseline, and after two years. Regression models for each gender were used to assess the variables associated with depression and pain incidence and persistence. Results Prevalences of depression, pain, and depression-pain co-occurrence, were higher in women than in men (depression: 34.5% vs. 20.3%; OR=2.1; 95% CI=1.9-2.2; pain: 60.2% vs. 53.5%; OR=1.3; 95% CI=1.2-1.4; co-occurrence 25.3% vs. 14.0%; OR=2.3; 95% CI=2.2-2.6). Treated baseline pain in women (OR=1.6; 95% CI=1.3-2.0), and treated/untreated pain in men (untreated OR=1.3; 95% CI=1.1-1.7; treated OR=2.0; 95% CI=1.5-2.7), were associated with incident depression. Untreated baseline depression was associated with incident pain (women OR=1.3; 95% CI=1.1-1.7; men OR=1.8; 95% CI=1.3-2.6), and with persistent pain only in women (OR=1.3; 95% CI=1.1-1.6). Limitations We lack information on pain severity, and the consumption of analgesics was used as a proxy. We lack information on antidepressants and anxiolytics consumption separately. Participants were interviewed twice in two years, and pain/depression at both interviews were considered persistent although they may have relapsed and recurred. Conclusions Treated baseline pain is a risk factor for incident depression in both genders; untreated baseline pain is a risk factor only in men. Treating depression at baseline may protect from developing pain in both genders, and in women, it may also protect from pain persistence.
    No preview · Article · Dec 2015 · Journal of Affective Disorders
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    • "The first three response options were collated into the category 'good health' and the other two options into the category 'poor health'. Mental health was measured by the EURO-D scale for depression (Prince et al., 1999). The EURO-D scale consisted of twelve items, which were " depressed mood " , " pessimism " , " suicidality " , " guilt " , " sleep " , " interest " , " irritability " , " appetite " , " fatigue " , " concentration " , " enjoyment " and " tearfulness " . "
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    ABSTRACT: In Europe, the demand for informal care is high and will increase because of the ageing population. Although caregiving is intended to contribute to the care recipient's health, its effects on the health of older European caregivers are not yet clear. This study explores the association between providing informal personal care and the caregivers' health. Data were used from the longitudinal cohort (2004-2009) of the Survey of Health, Ageing and Retirement in Europe (SHARE)(n=7858). Generalized estimating equations were used to explore the longitudinal association of informal care and the caregiver's health using poor self-rated health (less than good), poor mental health (EURO-D score for depression ≥4), and poor physical health (≥2 health complaints). Providing informal personal care was significantly associated with poor mental health (OR=1.23, 95%CI=1.04-1.47) and poor physical health (OR=1.18, 95%CI=1.01-1.38), after adjusting for various socio-demographic and health-related factors. No statistical significant association was found for self-rated health in the adjusted models. Providing informal personal care may negative influence the caregiver's mental and physical health. More awareness of the beneficial and detrimental effects of caregiving among policy makers is needed to make well-informed decisions concerning the growth of care demands in the ageing population. Copyright © 2014 American Health Foundation. Published by Elsevier Inc. All rights reserved.
    Full-text · Article · Nov 2014 · Preventive Medicine
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    • "In contrast with our results and previous population-based studies, the geographical patterns in the EURODEP studies are somewhat less clear and show some noteworthy deviations. For example, a low prevalence of depressive symptoms is reported in Zaragore in Spain, while the highest prevalence is found in Munich, Germany (Copeland et al., 1999, 2004; Prince et al., 1999). The question arises of whether these differences are related to the more restrictive sampling of one city center per country or whether other mechanisms are at play. "
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    ABSTRACT: Depression is one of the most prevalent mental disorders in later life. However, despite considerable research attention, great confusion remains regarding the association between ageing and depression. There is doubt as to whether a depression scale performs identically for different age groups and countries. Although measurement equivalence is a crucial prerequisite for valid comparisons across age groups and countries, it has not been established for the eight-item version of the Centre for Epidemiological Studies Depression Scale (CES-D8). Using multi-group confirmatory factor analysis, we assess configural, metric, and scalar measurement equivalence across two age groups (50-64 years of age and 65 or older) in eleven European countries, employing data from the Survey of Health, Ageing, and Retirement (SHARE). Results indicate that the construct of depression is comparable across age and country groups, allowing the substantive interpretation of correlates and mean levels of depressive symptoms.
    Full-text · Article · Jul 2014 · Social Science Research
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