Legha Rupinder K, Gerbasi Margaret E, Smith Fawzi Mary C, Eustache Eddy, Therosme Tatiana, Fils-Aime J Reginald, Raviola Giuseppe J, Affricot Emmeline, Pierre Ermaze Louis, Alcindor Yoldie, Severe Jennifer, Boyd Katherine A, Grelotti David J, Darghouth Sarah, Rasmussen Andrew, Becker Anne E
1Center for Health Services and Society, University of California, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90045 USA.
2Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115 USA.
Confl Health. 2020 Feb 28;14:13. doi: 10.1186/s13031-020-0250-9. eCollection 2020.
The Zanmi Lasante Depression Symptom Inventory (ZLDSI) is a screening tool for major depression used in 12 primary care clinics in Haiti's Central Plateau. Although previously validated in a clinic-based sample, the present study is the first to evaluate the validity and clinical utility of the ZLDSI for depression screening in a school-based population in central Haiti.
We assessed depressive symptoms in a school-based sample of transitional age youth (18-22 years; = 120) with the ZLDSI. Other mental health-related assessments included a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) for current Major Depressive Episode, the Center for Epidemiologic Studies Depression Scale, and selected items adapted from the Global School-Based Health Survey mental health module. Diagnostic assignments of major depressive episode (MDE) were based on modified SCID interviews.
The ZLDSI demonstrated good overall accuracy in identifying current MDE (Area under the Curve = .92, 95% CI = .86, .98, < .001). We ascertained ≥12 as the optimal cut-off point to screen for depression with a sensitivity of 100% and a specificity of 73.9%. In addition, the ZLDSI was associated with other measures of depressive symptoms, suggesting that it demonstrates construct validity.
Study findings support that the ZLDSI has clinical utility for screening for depression among school-going transitional age youth.
赞米拉桑特抑郁症状量表（ZLDSI）是一种用于海地中部高原12家基层医疗诊所的重度抑郁症筛查工具。尽管该量表此前已在基于诊所的样本中得到验证，但本研究是首次评估ZLDSI在海地中部在校人群中进行抑郁症筛查的有效性和临床实用性。
我们使用ZLDSI对一个在校的过渡年龄青年样本（18 - 22岁；n = 120）进行抑郁症状评估。其他与心理健康相关的评估包括针对当前重度抑郁发作的改良版DSM-IV-TR轴I障碍结构化临床访谈（SCID）、流行病学研究中心抑郁量表，以及从全球学校健康调查心理健康模块中选取的项目。重度抑郁发作（MDE）的诊断依据是改良版SCID访谈。
ZLDSI在识别当前MDE方面显示出良好的总体准确性（曲线下面积 = 0.92，95%置信区间 = 0.86, 0.98，P < 0.001）。我们确定≥12为筛查抑郁症的最佳临界点，其灵敏度为100%，特异度为73.9%。此外，ZLDSI与其他抑郁症状测量指标相关，表明它具有结构效度。
研究结果支持ZLDSI在筛查在校过渡年龄青年抑郁症方面具有临床实用性。
