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      Identifying Depression in South Asian Patients with End-Stage Renal Disease: Considerations for Practice

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          Abstract

          Depression is a prevalent burden for patients with end-stage renal disease (ESRD) and one that is under-recognized and consequently under-treated. Although several studies have explored the association between depression symptoms, treatment adherence and outcomes in Euro-American patient groups, quantitative and qualitative exploration of these issues in patients from different cultural and ethnic backgrounds has been lacking. This review discusses the methodological issues associated with measuring depression in patients of South Asian origin who have a 3- to 5-fold greater risk of developing ESRD. There is a need to advance research into the development of accurate screening practices for this patient group, with an emphasis on studies utilizing rigorous approaches to evaluating the use of both emic (culture-specific) and etic (universal or culture-general) screening instruments.

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          Most cited references 95

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          The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

           L Radloff (1977)
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            The hospital anxiety and depression scale.

             R Snaith,  S Zigmond (1983)
            A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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              The validity of two versions of the GHQ in the WHO study of mental illness in general health care.

              In recent years the 12-item General Health Questionnaire (GHQ-12) has been extensively used as a short screening instrument, producing results that are comparable to longer versions of the GHQ. The validity of the GHQ-12 was compared with the GHQ-28 in a World Health organization study of psychological disorders in general health care. Results are presented for 5438 patients interviewed in 15 centres using the primary care version of the Composite International Diagnostic Instrument, or CIDI-PC. Results were uniformly good, with the average area under the ROC curve 88, range from 83 to 95. Minor variations in the criteria used for defining a case made little difference to the validity of the GHQ, and complex scoring methods offered no advantages over simpler ones. The GHQ was translated into 10 other languages for the purposes of this study, and validity coefficients were almost as high as in the original language. There was no tendency for the GHQ to work less efficiently in developing countries. Finally gender, age and educational level are shown to have no significant effect on the validity of the GHQ. If investigators wish to use a screening instrument as a case detector, the shorter GHQ is remarkably robust and works as well as the longer instrument. The latter should only be preferred if there is an interest in the scaled scores provided in addition to the total score.
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                Author and article information

                Journal
                Nephron Extra
                NNE
                Nephron Extra
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.ch )
                1664-5529
                Jan-Dec 2011
                28 December 2011
                28 December 2011
                : 1
                : 1
                : 262-271
                Affiliations
                School of Psychology, University of Hertfordshire, Hatfield, UK
                Author notes
                *Dr. Shivani Sharma, School of Psychology, University of Hertfordshire, College Lane, Hatfield AL10 9AB (UK), E-Mail s.3.sharma@ 123456herts.ac.uk
                Article
                nne-0001-0262
                10.1159/000331446
                3290835
                22470400
                Copyright © 2011 by S. Karger AG, Basel

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License ( http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.

                Counts
                References: 84, Pages: 10
                Categories
                Minireview

                Nephrology

                end-stage renal disease, screening, depression, measurement, south asians

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