Validation and factor structure of the Thai version of the EURO-D scale for depression among older psychiatric patients

• Published in: Aging & mental health 2009-11, Vol.13 (6), p.899-904
• Main Authors: Jirapramukpitak, Tawanchai, Darawuttimaprakorn, Niphon, Punpuing, Sureeporn, Abas, Melanie
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Area Under Curve; Construct validity; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - psychology; depressive disorders; Europe; Female; Geriatric Assessment - methods; Health care; Humans; Interview, Psychological - methods; Male; Middle Aged; Pessimism; Predictive Value of Tests; Principal Component Analysis; Psychiatric clinics; Psychiatrists; Psychiatry; Reproducibility of Results; Screening; Sensitivity; Sensitivity and Specificity; Thailand; validation studies; Validity
• ISSN: 1360-7863; 1364-6915
• DOI: 10.1080/13607860903046479

Objectives: To assess the concurrent and the construct validity of the Euro-D in older Thai persons. Method: Eight local psychiatrists used the major depressive episode section of the Mini International Neuropsychiatric Interview to interview 150 consecutive psychiatric clinic attendees. A trained interviewer administered the Euro-D. We used receiver operating characteristic (ROC) analysis to assess the overall discriminability of the Euro-D scale and principal components factor analysis to assess its construct validity. Results: The area under the ROC curve for the Euro-D with respect to major depressive episode was 0.78 [95% confidence interval (CI) 0.70-0.90] indicating moderately good discriminability. At a cut-point of 5/6 the sensitivity for major depressive episodes is 84.3%, specificity 58.6%, and kappa 0.37 (95% CI 0.22-0.52) indicating fair concordance. However, at the 3/4 cut-point recommended from European studies there is high sensitivity (94%) but poor specificity (34%). The principal components analysis suggested four factors. The first two factors conformed to affective suffering (depression, suicidality and tearfulness) and motivation (interest, concentration and enjoyment). Sleep and appetite constituted a separate factor, whereas pessimism loaded on its own factor. Conclusion: Among Thai psychiatric clinic attendees Euro-D is moderately valid for major depression. A much higher cut-point may be required than that which is usually advocated. The Thai version also shares two common factors as reported from most of previous studies.