Broekman B F P, Nyunt S Z, Niti M, Jin A Z, Ko S M, Kumar R, Fones C S L, Ng T P
Department of Psychological Medicine, National University of Singapore, Singapore.
J Affect Disord. 2008 Jun;108(3):285-90. doi: 10.1016/j.jad.2007.10.005. Epub 2007 Nov 13.
The Geriatric Depression Scale (GDS) is widely used for screening and assessment of major depressive disorder (MDD). Screening scales are often culture-specific and should be evaluated for item response bias (synonymously differential item functioning, DIF) before use in clinical practice and research in a different population. In this study, we examined DIF associated with age, gender, ethnicity and chronic illness in a heterogeneous Asian population in Singapore.
The GDS-15 and Structured Clinical Interview for DSM-IV diagnosis of MDD were independently administered by interviewers on 4253 non-institutionalized community living elderly subjects aged 60 years and above who were users of social service agencies. Multiple Indicator Multiple Cause latent variable modelling was used to identify DIF.
We found evidence of significant DIF associated with age, gender, ethnicity and chronic illness for 8 items: dropped many activities and interests, afraid something bad is going to happen, prefer staying home to going out, more problems with memory than most, think it is (not) wonderful to be alive, feel pretty worthless, feel (not) full of energy, feel that situation is hopeless.
The smaller number of minority Indian and Malay subjects and the self-report of chronic medical illnesses.
In a heterogeneous mix of respondents in Singapore, eight items of the GDS-15 showed DIF for age, gender, ethnicity and chronic illness. The awareness and identification of DIF in the GDS-15 provides a rational basis for its use in diverse population groups and guiding the derivation of abbreviated scales.
老年抑郁量表（GDS）广泛用于重度抑郁症（MDD）的筛查和评估。筛查量表通常具有文化特异性，在用于不同人群的临床实践和研究之前，应评估其项目反应偏差（同义词：项目功能差异，DIF）。在本研究中，我们在新加坡一个异质性亚洲人群中检验了与年龄、性别、种族和慢性病相关的DIF。
由访谈者对4253名60岁及以上、居住在社区且未入住机构的老年受试者独立施测GDS - 15和用于DSM - IV诊断MDD的结构化临床访谈。采用多指标多原因潜在变量模型来识别DIF。
我们发现8个项目存在与年龄、性别、种族和慢性病相关的显著DIF证据：放弃了许多活动和兴趣、担心会发生不好的事情、比起外出更喜欢待在家里、记忆力问题比大多数人多、认为活着（不）美好、觉得自己毫无价值、感觉（不）精力充沛、觉得情况毫无希望。
少数印度和马来受试者数量较少以及慢性疾病的自我报告。
在新加坡的异质性受访者群体中，GDS - 15的8个项目在年龄、性别、种族和慢性病方面显示出DIF。对GDS - 15中DIF的认识和识别为其在不同人群中的使用以及指导简化量表的推导提供了合理依据。
