Validity of the brief Zung's scale for screening major depressive episode among the general population from Bucaramanga, Colombia
Keywords:
validation studies, mass screening, urban population, adult
Abstract
Introduction. Brief scales for identiying depressive disorder are as useful as long scales for screening. However, a validated scale with these characteristics is not avalaible in Colombia.Objective. To design a brief Zung's self-rating depression scale in order to screen major depressive episodes among adults dwelling in the general community.
Materials and methods. After filling-out the 20-item Zung's self-rating depression scale, the ten items with the higher correlation with total score were selected. Construct and criterion validity were computed for these ten items.
Results. The ten chosen items showed an internal consistency of 0,803, one factor that accounted for 36,6% of the variance; sensitivity was 95,5%; specificity, 70,3%; Cohen's kappa, 0,415; and area under receptor-operator curve, 0,898.
Conclusions. The brief Zung's self-rating depression scale exhibits psychometric properties similar to the long version. This brief scale can be used as a screening device in the general population.
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References
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4. Rodríguez CE, Puerta G. Prevalencia de síntomas de depresión y ansiedad en los pacientes de la consulta no psiquiátrica. Rev Colomb Psiquiatr 1997;26:273-88.
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6. Allonier C, Chevalier A, Zins M, Catelinois O, Consoli SM, Lahon G. Anxiety or depressive disorders and risk of ischaemic heart disease among French power company employees. Int J Epidemiol
2004;33:779-86.
7. Nothwehr F, Stump T. Health-promoting behaviors among adults with type 2 diabetes: findings from the Health and Retirement Study. Prev Med 2000;30:407-14.
8. Thomas CM, Morris S. Cost of depression among adults in England in 2000. Br J Psychiatry 2003;183:514-9.
9. Pignone MP, Gaynes BN, Rushton JL, Burchell CM, Orleans CT, Mulrow CD, et al. Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;136:765-76.
10. Torres Y, Murelle L. Estudio Nacional sobre Alcoholismo y Consumo de Sustancias Psicoactivas- Colombia 1987. Medellín: Editorial Universidad de Antioquia; 1988.
11. Torres Y, Posada J. Estudio Nacional de Salud Mental y Consumo de Substancias Psicoactivas. Bogotá: Ministerio de Salud; 1993.
12. Zung WW. A self-report depression scale. Arch Gen Psychiatry 1965;12:63-70.
13. Raft D, Spencer RF, Toomey T, Brogan D. Depression in medical outpatients: use of the Zung scale. Dis Nerv Syst 1977;38:999-1004.
14. Chida F, Kayama A, Nishi N, Sakai A. Factor analysis of Zung Scale scores in a Japanese general population. Psychiatry Clin Neurosci 2004;58:420-6.
15. Kitamura T, Hirano H, Chen Z, Hirata M. Factor structure of the Zung Self-rating Depression Scale in first-year university students in Japan. Psychiatry Res 2004;128:281-7.
16. Tucker MA, Ogle SJ, Davidson JG, Eilenberg MD. Validation of a brief screening test for depression in the elderly. Age Ageing 1987;16:139-44.
17. Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult. Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 1999;159:1701-4.
18. Lelito RH, Palumbo LO, Hanley M. Psychometric evaluation of a brief geriatric depression screen. Aging Ment Health 2001;5:387-93.
19. Chochinov HM, Wilson KG, Enns M, Lander S. "Are you depressed?" Screening for depression in the terminally ill. Am J Psychiatry 1997;154:674-6.
20. Mallon L, Hetta J. Detección de la depresión mediante cuestionarios: comparación de una sola pregunta con los datos de la entrevista en una muestra de adultos de edad avanzada. Eur J Psychiatry 2002;16:139-48.
21. Arroll B, Khin N, Kerse N. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ 2003;327:1144-6.
22. Jaju A, Crask MR. The perfect design: optimization between reliability, validity, redundancy in scale items and response rates. Am Market Assoc 1999;10:127-31.
23. Streiner DL. Figuring out factors: the use and misuse of factor analysis. Can J Psychiatry 1994;39:135-40.
24. Díaz LA, Campo A, Rueda GE, Barros JA. Propuesta de una versión abreviada de la escala de Zung. Colomb Med 2005;36:168-72.
25. Blacker D, Endicott J. Psychometric properties: concepts of reliability and validity. En: Rush AJ, Pincus HA, First MB, Zarin DA, Blacker D, Endicott J et al. Handbook of psychiatric measures. Washington D.C.: American Psychiatric Association; 2002 (CD-ROM).
26. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977;1:385-401.
27. Campo-Arias A, Díaz-Martínez LA, Rueda-Jaimes GE, Cadena LP, Hernández NL. Validation of Zung's self-rating depression scale among the Colombian general population. Soc Behav Pers 2006;34:87-94.
28. Chmura H. Evaluating medical test. Objective and quantitative guidelines. Newbury Park: Sage Publications Inc; 1992.
29. Gómez-Restrepo C, Bohórquez A, Pinto D, Gill JF, Rondón M, Díaz-Granados N. Prevalencia de depresión y factores asociados con ella en la población colombiana. Rev Panam Salud Pública 2004;16:378-
86.
30. First MB, Spitzer RL, Gibbon M, Williams JB. Entrevista clínica estructurada para los trastornos de eje I del DSM-IV (versión clínica) SCID-I. Barcelona: Masson; 1999.
31. Ferré L. Selection of components in principal component analysis: a comparison of methods. Comput Stat Data Anal 1995;19:669-82.
32. Hogarty KY, Hines CV, Kromey JD, Ferron JM, Mumford KR. The quality of factor solutions in exploratory factor analysis: the influence of sample size, communality, and overdetermination. Educ Psychol Meas 2005;65:202-26.
33. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating curves: a nonparametric approach. Biometrics 1988;44:837-45.
34. Cronbach LJ. Coefficient alpha and the internal structure of test. Psychometrika 1951;16:297-334.
35. Norman GR, Streiner DL. Bioestadística. Madrid: Mosby/Doyma Libros; 1996. p.129-48. 36. Kaiser HF. An index of factorial simplicity. Psychometrika 1974;39:31-6.
37. Gorsuch RL. Exploratory factor analysis: its role in item analysis. J Pers Asses 1997;68:532-60.
38. Rey JM, Morris-Yates A, Stanislaw H. Measuring the accuracy of diagnostic test using receiver operating characteristics (ROC) analysis. Int J Method Psychiatr Res 1992;2:39-50.
39. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas 1960;20:37-46.
40. Stata Corporation. STATA for windows 9.0. College Station: StataCorp LP; 2005.
41. Sánchez R, Gómez C. Conceptos básicos sobre validación de escalas. Rev Colomb Psiquiatr 1998;27:121-30.
42. Cortina JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol 1993;78:98-104.
43. Nease DE Jr, Aikens JE. DSM depression and anxiety criteria and severity of symptoms in primary care: cross sectional study. BMJ 2003;327:1030-1.
44. Kessler D, Bennewith O, Lewis G, Sharp D. Detection of depression and anxiety in primary care: follow up study. BMJ 2002;325:1016-7.
45. Spector P. Summated rating scale construction. Thousands Oaks, CA: Sage Publications; 1992.
46. Kroenke K. Depression screening is not enough. Ann Intern Med 2001;134:418-20.
47. Rubio-Stipec M, Hicks MH, Tsuang MT. Cultural factors influencing the selection, use, and interpretation of psychiatric measures. En: Rush AJ, Pincus HA, First MB, Zarin DA, Blacker D, Endicott J et al. Handbook of psychiatric measures. Washington D.C.: American Psychiatric Association; 2002 (CD-ROM).
48. Byrt T, Bishop J, Carlin JB. Bias, prevalence and kappa. J Clin Epidemiol 1993;46:423-9.
49. Streiner DL. Diagnosing tests: using and misusing diagnostic and screening tests. J Person Assess 2003;81:209-19.
50. Whiting P, Rutjes AW, Reitsma JB, Glas AS, Bossuyt PM, Kleijnen J. Sources of variation and bias in studies of diagnostic accuracy. A systematic review. Ann Intern Med 2004;140:189-202.
51. Zung WW. Zung self-rating depression scale (Zung SDS). En: Rush AJ, Pincus HA, First MB, Zarin DA, Blacker D, Endicott J et al. Handbook of psychiatric measures. Washington D.C.: American Psychiatric Association; 2002 (CD-ROM).
52. Campo-Arias A, Díaz-Martínez LA, Rueda-Jaimes GE, Barros-Bermúdez JA. Validación de la escala de Zung para depresión en universitarias de Bucaramanga, Colombia. Rev Colomb Psiquiatr 2005;34:54-62.
2. Posada-Villa JA, Trevisi C. Prevalencia, severidad y necesidades no satisfechas del tratamiento de los trastornos de ansiedad, relacionados con sustancias, del estado de ánimo y del control de impulsos en adultos según el Estudio Nacional de Salud Mental, Colombia, 2003. Medunab 2004;7:65-72.
3. Posada-Villa JA, Aguilar-Gaxiola SA, Magaña CG, Gómez LC. Prevalencia de trastornos mentales y uso de servicios: resultados preliminares del Estudio Nacional de Salud Mental, Colombia, 2003. Rev Colomb Psiquiatr 2004;33:241-62.
4. Rodríguez CE, Puerta G. Prevalencia de síntomas de depresión y ansiedad en los pacientes de la consulta no psiquiátrica. Rev Colomb Psiquiatr 1997;26:273-88.
5. Üstün TB, Ayuso-Mateos L, Chatterji S, Mathers C, Murray CJ. Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004;184:386-92.
6. Allonier C, Chevalier A, Zins M, Catelinois O, Consoli SM, Lahon G. Anxiety or depressive disorders and risk of ischaemic heart disease among French power company employees. Int J Epidemiol
2004;33:779-86.
7. Nothwehr F, Stump T. Health-promoting behaviors among adults with type 2 diabetes: findings from the Health and Retirement Study. Prev Med 2000;30:407-14.
8. Thomas CM, Morris S. Cost of depression among adults in England in 2000. Br J Psychiatry 2003;183:514-9.
9. Pignone MP, Gaynes BN, Rushton JL, Burchell CM, Orleans CT, Mulrow CD, et al. Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;136:765-76.
10. Torres Y, Murelle L. Estudio Nacional sobre Alcoholismo y Consumo de Sustancias Psicoactivas- Colombia 1987. Medellín: Editorial Universidad de Antioquia; 1988.
11. Torres Y, Posada J. Estudio Nacional de Salud Mental y Consumo de Substancias Psicoactivas. Bogotá: Ministerio de Salud; 1993.
12. Zung WW. A self-report depression scale. Arch Gen Psychiatry 1965;12:63-70.
13. Raft D, Spencer RF, Toomey T, Brogan D. Depression in medical outpatients: use of the Zung scale. Dis Nerv Syst 1977;38:999-1004.
14. Chida F, Kayama A, Nishi N, Sakai A. Factor analysis of Zung Scale scores in a Japanese general population. Psychiatry Clin Neurosci 2004;58:420-6.
15. Kitamura T, Hirano H, Chen Z, Hirata M. Factor structure of the Zung Self-rating Depression Scale in first-year university students in Japan. Psychiatry Res 2004;128:281-7.
16. Tucker MA, Ogle SJ, Davidson JG, Eilenberg MD. Validation of a brief screening test for depression in the elderly. Age Ageing 1987;16:139-44.
17. Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult. Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 1999;159:1701-4.
18. Lelito RH, Palumbo LO, Hanley M. Psychometric evaluation of a brief geriatric depression screen. Aging Ment Health 2001;5:387-93.
19. Chochinov HM, Wilson KG, Enns M, Lander S. "Are you depressed?" Screening for depression in the terminally ill. Am J Psychiatry 1997;154:674-6.
20. Mallon L, Hetta J. Detección de la depresión mediante cuestionarios: comparación de una sola pregunta con los datos de la entrevista en una muestra de adultos de edad avanzada. Eur J Psychiatry 2002;16:139-48.
21. Arroll B, Khin N, Kerse N. Screening for depression in primary care with two verbally asked questions: cross sectional study. BMJ 2003;327:1144-6.
22. Jaju A, Crask MR. The perfect design: optimization between reliability, validity, redundancy in scale items and response rates. Am Market Assoc 1999;10:127-31.
23. Streiner DL. Figuring out factors: the use and misuse of factor analysis. Can J Psychiatry 1994;39:135-40.
24. Díaz LA, Campo A, Rueda GE, Barros JA. Propuesta de una versión abreviada de la escala de Zung. Colomb Med 2005;36:168-72.
25. Blacker D, Endicott J. Psychometric properties: concepts of reliability and validity. En: Rush AJ, Pincus HA, First MB, Zarin DA, Blacker D, Endicott J et al. Handbook of psychiatric measures. Washington D.C.: American Psychiatric Association; 2002 (CD-ROM).
26. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977;1:385-401.
27. Campo-Arias A, Díaz-Martínez LA, Rueda-Jaimes GE, Cadena LP, Hernández NL. Validation of Zung's self-rating depression scale among the Colombian general population. Soc Behav Pers 2006;34:87-94.
28. Chmura H. Evaluating medical test. Objective and quantitative guidelines. Newbury Park: Sage Publications Inc; 1992.
29. Gómez-Restrepo C, Bohórquez A, Pinto D, Gill JF, Rondón M, Díaz-Granados N. Prevalencia de depresión y factores asociados con ella en la población colombiana. Rev Panam Salud Pública 2004;16:378-
86.
30. First MB, Spitzer RL, Gibbon M, Williams JB. Entrevista clínica estructurada para los trastornos de eje I del DSM-IV (versión clínica) SCID-I. Barcelona: Masson; 1999.
31. Ferré L. Selection of components in principal component analysis: a comparison of methods. Comput Stat Data Anal 1995;19:669-82.
32. Hogarty KY, Hines CV, Kromey JD, Ferron JM, Mumford KR. The quality of factor solutions in exploratory factor analysis: the influence of sample size, communality, and overdetermination. Educ Psychol Meas 2005;65:202-26.
33. DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating curves: a nonparametric approach. Biometrics 1988;44:837-45.
34. Cronbach LJ. Coefficient alpha and the internal structure of test. Psychometrika 1951;16:297-334.
35. Norman GR, Streiner DL. Bioestadística. Madrid: Mosby/Doyma Libros; 1996. p.129-48. 36. Kaiser HF. An index of factorial simplicity. Psychometrika 1974;39:31-6.
37. Gorsuch RL. Exploratory factor analysis: its role in item analysis. J Pers Asses 1997;68:532-60.
38. Rey JM, Morris-Yates A, Stanislaw H. Measuring the accuracy of diagnostic test using receiver operating characteristics (ROC) analysis. Int J Method Psychiatr Res 1992;2:39-50.
39. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas 1960;20:37-46.
40. Stata Corporation. STATA for windows 9.0. College Station: StataCorp LP; 2005.
41. Sánchez R, Gómez C. Conceptos básicos sobre validación de escalas. Rev Colomb Psiquiatr 1998;27:121-30.
42. Cortina JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol 1993;78:98-104.
43. Nease DE Jr, Aikens JE. DSM depression and anxiety criteria and severity of symptoms in primary care: cross sectional study. BMJ 2003;327:1030-1.
44. Kessler D, Bennewith O, Lewis G, Sharp D. Detection of depression and anxiety in primary care: follow up study. BMJ 2002;325:1016-7.
45. Spector P. Summated rating scale construction. Thousands Oaks, CA: Sage Publications; 1992.
46. Kroenke K. Depression screening is not enough. Ann Intern Med 2001;134:418-20.
47. Rubio-Stipec M, Hicks MH, Tsuang MT. Cultural factors influencing the selection, use, and interpretation of psychiatric measures. En: Rush AJ, Pincus HA, First MB, Zarin DA, Blacker D, Endicott J et al. Handbook of psychiatric measures. Washington D.C.: American Psychiatric Association; 2002 (CD-ROM).
48. Byrt T, Bishop J, Carlin JB. Bias, prevalence and kappa. J Clin Epidemiol 1993;46:423-9.
49. Streiner DL. Diagnosing tests: using and misusing diagnostic and screening tests. J Person Assess 2003;81:209-19.
50. Whiting P, Rutjes AW, Reitsma JB, Glas AS, Bossuyt PM, Kleijnen J. Sources of variation and bias in studies of diagnostic accuracy. A systematic review. Ann Intern Med 2004;140:189-202.
51. Zung WW. Zung self-rating depression scale (Zung SDS). En: Rush AJ, Pincus HA, First MB, Zarin DA, Blacker D, Endicott J et al. Handbook of psychiatric measures. Washington D.C.: American Psychiatric Association; 2002 (CD-ROM).
52. Campo-Arias A, Díaz-Martínez LA, Rueda-Jaimes GE, Barros-Bermúdez JA. Validación de la escala de Zung para depresión en universitarias de Bucaramanga, Colombia. Rev Colomb Psiquiatr 2005;34:54-62.
How to Cite
1.
Campo A, Díaz LA, Rueda GE. Validity of the brief Zung’s scale for screening major depressive episode among the general population from Bucaramanga, Colombia. biomedica [Internet]. 2006 Sep. 1 [cited 2024 May 18];26(3):415-23. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/360
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