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      Validation of the Rasch-based Depression Screening in a large scale German general population sample

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          Abstract

          Background

          The study aimed at presenting normative data for both parallel forms of the "Rasch-based Depression Screening (DESC)", to examine its Rasch model conformity and convergent and divergent validity based on a representative sample of the German general population.

          Methods

          The sample was selected with the assistance of a demographic consulting company applying a face to face interview (N = 2509; mean age = 49.4, SD = 18.2; 55.8% women). Adherence to Rasch model assumptions was determined with analysis of Rasch model fit (infit and outfit), unidimensionality, local independence (principal component factor analysis of the residuals, PCFAR) and differential item functioning (DIF) with regard to participants' age and gender. Norm values were calculated. Convergent and divergent validity was determined through intercorrelations with the depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS-D and HADS-A).

          Results

          Fit statistics were below critical values (< 1.3). There were no signs of DIF. The PCFAR revealed that the Rasch dimension "depression" explained 68.5% (DESC-I) and 69.3% (DESC-II) of the variance, respectively which suggests unidimensionality and local independence of the DESC. Correlations with HADS-D were r DESC-I = .61 and r DESC-II = .60, whereas correlations with HADS-A were r DESC-I = .62 and r DESC-II = .60.

          Conclusions

          This study provided further support for the psychometric quality of the DESC. Both forms of the DESC adhered to Rasch model assumptions and showed intercorrelations with HADS subscales that are in line with the literature. The presented normative data offer important advancements for the interpretation of the questionnaire scores and enhance its usefulness for clinical and research applications.

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          Most cited references 31

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          The CES-depression scale: a self-report depression scale for research in the general population

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            Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians? diagnoses

             Craig B. Lowe (2004)
            The aim of this study was to compare the validity of the Hospital Anxiety and Depression Scale (HADS), the WHO (five) Well Being Index (WBI-5), the Patient Health Questionnaire (PHQ), and physicians' recognition of depressive disorders, and to recommend specific cut-off points for clinical decision making. A total of 501 outpatients completed each of the three depression screening questionnaires and received the Structured Clinical Interview for DSM-IV (SCID) as the criterion standard. In addition, treating physicians were asked to give their psychiatric diagnoses. Criterion validity and Receiver Operating Characteristics (ROC) were determined. Areas under the curves (AUCs) were compared statistically. All depression scales showed excellent internal consistencies (Cronbach's alpha: 0.85-0.90). For 'major depressive disorder', the operating characteristics of the PHQ were significantly superior to both the HADS and the WBI-5. For 'any depressive disorder', the PHQ showed again the best operating characteristics but the overall difference did not reach statistical significance at the 5% level. Cut-off points that can be recommended for the screening of 'major depressive disorder' had sensitivities of 98% (PHQ), 94% (WBI-5), and 85% (HADS). Corresponding specificities were 80% (PHQ), 78% (WBI-5), and 76% (HADS). In contrast, physicians' recognition of 'major depressive disorder' was poor (sensitivity, 40%; specificity, 87%). Our sample may not be representative of medical outpatients, but sensitivity and specificity are independent of disorder prevalence. All three questionnaires performed well in depression screening, but significant differences in criterion validity existed. These results may be helpful in the selection of questionnaires and cut-off points.
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              Methods for defining and determining the clinical significance of treatment effects: description, application, and alternatives.

              This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications. Future directions for this methodology are proposed.
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                Author and article information

                Journal
                Health Qual Life Outcomes
                Health and Quality of Life Outcomes
                BioMed Central
                1477-7525
                2010
                21 September 2010
                : 8
                : 105
                Affiliations
                [1 ]Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
                [2 ]Institute of Psychology, University of Education Freiburg, Kartäuserstr. 61b, 79117 Freiburg, Germany
                [3 ]Department of Medical Psychology and Medical Sociology, University of Leipzig, Phillipp- Rosenthal-Straße 55, 04103 Leipzig, Germany
                [4 ]Department of Psychiatry and Psychotherapy, LWL-University-Clinic, Ruhr-University Bochum, Alexandrinenstr. 1-3, 44791 Bochum, Germany
                Article
                1477-7525-8-105
                10.1186/1477-7525-8-105
                2954976
                20858272
                Copyright ©2010 Forkmann et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research

                Health & Social care

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