Guerra Mariella, Ferri Cleusa, Llibre Juan, Prina A Matthew, Prince Martin
Institute of Memory, Depression and Disease Risk, Avda Constructores 1230, Lima, 12, Peru.
Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
BMC Psychiatry. 2015 Feb 5;15:12. doi: 10.1186/s12888-015-0390-4.
Many of the assessment tools used to study depression among older people are adaptations of instruments developed in other cultural setting. There is a need to validate those instruments in low and middle income countries (LMIC).
A one-phase cross-sectional survey of people aged [greater than or equal to] 65 years from LMIC. EURO-D was checked for psychometric properties. Calibration with clinical diagnosis was made using ICD-10. Optimal cutpoint was determined. Concurrent validity was assessed measuring correlations with WHODAS 2.0.
17,852 interviews were completed in 13 sites from nine countries. EURO-D constituted a hierarchical scale in most sites. The most commonly endorsed symptom in Latin American sites was depression; in China was sleep disturbance and tearfulness; in India, irritability and fatigue and in Nigeria loss of enjoyment. Two factor structure (affective and motivation) were demonstrated. Measurement invariance was demonstrated among Latin American and Indian sites being less evident in China and Nigeria. At the 4/5 cutpoint, sensitivity for ICD-10 depressive episode was 86% or higher in all sites and specificity exceeded 84% in all Latin America and Chinese sites. Concurrent validity was supported, at least for Latin American and Indian sites.
There is evidence for the cross-cultural validity of the EURO-D scale at Latin American and Indian settings and its potential applicability in comparative epidemiological studies.
许多用于研究老年人抑郁症的评估工具是对在其他文化背景下开发的工具的改编。有必要在低收入和中等收入国家（LMIC）对这些工具进行验证。
对来自LMIC的65岁及以上人群进行单阶段横断面调查。检查了EURO-D量表的心理测量特性。使用国际疾病分类第10版（ICD-10）与临床诊断进行校准。确定了最佳切点。通过测量与世界卫生组织残疾评定量表2.0（WHODAS 2.0）的相关性来评估同时效度。
在来自9个国家的13个地点完成了17,852次访谈。在大多数地点，EURO-D构成了一个分层量表。在拉丁美洲地区最常被认可的症状是抑郁；在中国是睡眠障碍和流泪；在印度是易怒和疲劳；在尼日利亚是失去乐趣。证实了双因素结构（情感和动机）。在拉丁美洲和印度地区之间证明了测量不变性，在中国和尼日利亚则不太明显。在4/5切点时，所有地点对ICD-10抑郁发作的敏感性均为86%或更高，在所有拉丁美洲和中国地区特异性超过84%。至少在拉丁美洲和印度地区支持了同时效度。
有证据表明EURO-D量表在拉丁美洲和印度背景下具有跨文化效度及其在比较流行病学研究中的潜在适用性。
