The Spanish version of the FibroFatigue Scale: validation of a questionnaire for the observer's assessment of fibromyalgia and chronic fatigue syndrome

OBJECTIVE: To examine some of the psychometric properties of the Spanish version of the FibroFatigue Scale (FFS). METHODS: FFS was administered to 120 patients diagnosed with fibromyalgia and chronic fatigue syndrome. Internal consistency was evaluated by using Cronbach's alpha, test-retest reliability with weighted kappa and construct validity by correlations among FFS, the Fibromyalgia Impact Questionnaire (FIQ), the EuroQol 5D (EQ-5D) and the Hospital Anxiety and Depression Scale (HADS). The interrater reliability was tested using analysis of variance with patients and raters as independent factors. RESULTS: Internal consistency (alpha) was .88, test-retest reliability was .91, and interrater reliability was .93. Significant correlations were obtained between overall FFS and the FIQ (.55, P<.01), the EQ-5D (-.48, P<.01) and the HADS depression subscale (.25, P<.01), but not with the HADS anxiety subscale. CONCLUSION: These results support the reliability and validity of the data obtained with the Spanish version of the FSS.     

Panic Disorder Severity Scale: reliability and validity of the Turkish version

We assessed the reliability and validity of the Turkish version of the seven-item Panic Disorder Severity Scale (PDSS). We recruited 174 subjects, including 104 with current DSM-IV panic disorder with (n=76) or without(n=28)agoraphobia, 14 with a major depressive episode, 24 with a non-panic anxiety disorder, and 32 healthy controls. Assessment instruments were Panic Disorder Severity Scale, Panic and Agoraphobia Scale, both the observer-rated (P&Ao) and self-rating (P& Asr); Clinical Global Impression Scale (CGI); Hamilton Anxiety Scale, and Beck Depression Inventory. We repeated the measures for a group of panic disorder patients (n = 51) after 4 weeks to assess test-retest reliability. The internal consistency (Cronbach's alpha) of the PDSS was .92-94. The inter-rater correlation coefficient was .79. The test-retest correlation coefficient after 4 weeks was .63. In discriminant validity analyses, the highest correlation for PDSS was with P&Ao, P&Asr (r=.87 and.87, respectively) and CGI (r=.76) and the lowest with Beck Depression Inventory (r=.29). The cut-off point was six/seven, associated with high sensitivity (99%) and specificity (98%). This study confirmed the objectivity, reliability and validity of the Turkish version of the PDSS.     

Psychometric properties of the Spanish self-report version of the Panic Disorder Severity Scale

Objective

The goal of the study was to assess the psychometric properties and the factor structure of the Spanish self-report version of the Panic Disorder Severity Scale (PDSS-SR).

Method

One hundred and twenty four patients meeting DSM-IV criteria for panic disorder were assessed with the Spanish PDSS-SR, the Anxiety Sensitivity Index-3 (ASI-3), the Sheehan Disability Inventory (SDI) and the Beck Depression Inventory-II (BDI-II). Cronbach's alpha was used to evaluate internal consistency. Pearson correlations were used to evaluate test-retest reliability, convergent and divergent validity. Sensitivity to change data was obtained for 91 patients that had completed a cognitive behavioural therapy. The factor structure was analysed using a confirmatory factor analysis (CFA).

Results

The Spanish PDSS-SR showed excellent internal consistency, good test-retest reliability and adequate convergent validity. Regarding divergent validity, the correlation with the BDI-II was larger than expected. The Spanish PDSS-SR was sensitive to change. Our CFA suggested a two-factor model for the scale.

Conclusions

The Spanish PDSS-SR has similar psychometric properties as the previous versions of the PDSS-SR and it can become a useful instrument to assess panic symptoms in clinical and research settings in Spanish-speaking countries.     

Validation of the Spanish version of the Side Effect and Life Satisfaction Inventory in patients with epilepsy

OBJECTIVE: The goal of the study described here was to obtain psychometric validation of the Spanish version of the 38-item Side Effects and Life Satisfaction (SEALS) Inventory. METHODS: A cross-cultural adaptation of the inventory was performed. A total of 595 patients with epilepsy were included in a multicenter cross-sectional study. The SEALS Inventory was completed, together with the Hospital Anxiety and Depression Scale and SF-12 Health Survey. RESULTS: The mean SEALS score was 60.7. SEALS presented high internal consistency, with a Cronbach alpha coefficient of 0.93, and good test-retest reliability, with an intraclass correlation coefficient of 0.92. The pattern of correlations with the Hospital Anxiety and Depression Scale and SF-12 Health Survey indicated good convergent and divergent validity. SEALS scores discriminated patients according to epilepsy-related factors, emotional disturbances, and the generic quality of life. CONCLUSION: The Spanish version of the SEALS Inventory is a valid psychometric instrument. It may be used in routine clinical practice and in clinical trials in patients with epilepsy to capture the cognitive and behavioral aspects of quality of life.     

Diagnostic Interview for Genetic Studies (DIGS): inter-rater and test-retest reliability and validity in a Spanish population.

OBJECTIVE: To test the reliability and validity of the DIGS in Spanish population. METHODS: Inter-rater and test-retest reliability of the Spanish version of DIGS was tested in 95 inpatients and outpatients. The resultant diagnoses were compared with diagnoses obtained by the LEAD (Longitudinal Expert All Data) procedure as "gold standard". The kappa statistic was used to measure concordance between blind inter-raters and between the diagnoses obtained by LEAD procedure and through the DIGS. RESULTS: Overall kappa coefficient for inter-rater reliability was 0.956. The kappa value for individual diagnosis varied from major depression=0.877 to schizophrenia=1. Test-retest reliability was 0.926. Kappa for all individual target diagnoses ranged from 0.776 (major depression) to 1. Kappa between LEAD procedure and DIGS ranged from 0.704 (major depression) to 0.825 (bipolar I disorder). CONCLUSION: Most of the DSM-IV major psychiatric disorders can be assessed with acceptable to excellent reliability with the Spanish version of the DIGS interview. The Spanish version of DIGS showed an acceptable to excellent concurrent validity. Giving the good reliability and validity of Spanish version of DIGS it should be considered to identify psychiatric phenotypes for genetics studies.     

Cross-cultural adaptation and validation of the Spanish version of the Calgary Depression Scale for Schizophrenia

BACKGROUND: The Calgary Depression Scale for Schizophrenia (CDSS) is a valid tool to assess depression in schizophrenics and has been translated, adapted, and validated to be used in different non-English languages. Therefore, it may be predicted that a Spanish version of this scale will be also a valid instrument to assess symptoms of depression in patients with schizophrenia. OBJECTIVE: We determined the validity of the Spanish version of the Calgary scale (CDSS-S). METHODS: Outpatients and inpatients (n=93) diagnosed as having schizophrenia by DSM-IV criteria confirmed by SCID-IV interview were included. The Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HDRS-17 and HDRS-21 items), Montgomery-Asberg Depression Rating Scale (MADRS), Extrapyramidal Symptoms Rating Scale (ESRS), and Barnes Acathisia Rating Scale were administered by a first rater, whereas the CDSS-S was assessed by a second independent rater. RESULTS: The internal consistency (Cronbach's alpha 0.83) and the interrater reliability (>0.73 intraclass correlation coefficient [ICC] for single items and 0.92 for total score) were good. The test-retest reliability was high (ICC of 0.89). The scale showed a good construct validity with statistically significant correlations with HDRS-17, HDRS-21, MADRS, and G6 item (depression) of PANSS. The CDSS showed no correlation with the positive subscale of PANSS and a weak correlation with the negative subscale, general psychopathology subscale, and total score of PANSS. A cut point of five showed 94.7% sensitivity, 86.5% specificity, and 70% and 98% positive and negative predictive values, respectively. CONCLUSIONS: The Spanish version of CDSS is a valid instrument to assess depressive episodes for stabilized and acute patients with schizophrenia.     

A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population

The present study aims to validate the Spanish version of the Hospital Anxiety and Depression Scale (HADS) and to determine the use of this tool for screening mood and anxiety disorders. Psychometric properties of the HADS were assessed in different groups of general medical outpatients attending the Hospital Clínic in Barcelona (N=385), and psychiatric diagnoses were made using DSM-IV criteria. A two-factor solution corresponding to the original two subscales of the HADS was found. The Spanish version of the HADS had good internal consistency and external validity, with favorable sensitivity and specificity in identifying cases of psychiatric disorder as defined by the Structured Clinical Interview for DSM-IV (SCID-I). The psychometric properties of the HADS and its brevity make it useful for screening for psychiatric disorders in the medically ill.     

医院焦虑抑郁量表在综合性医院中的应用

目的 评价医院焦虑和抑郁量表在综合性医院住院病人中应用的信度和效度。方法 应用医院焦虑抑郁量表(HADS)对846名住院病人进行调查,并与焦虑自评量表(SAS)和抑郁自评量表(SDS)做相关分析。结果 (1)通过因素分析得到3个相互关联的因素,抑郁、精神性焦虑、精神运动性激越。(2)不同病种分析,HADS具有较高的内部一致性。(3)相关分析得到该量表与SAS、SDS存在较高的相关。(4)通过与SAS、SDS的比较得到以9分作为HADS的筛选临界值是较可靠的。结论 医院焦虑抑郁量表作为综合性医院焦虑抑郁情绪的筛查工具还是较为可靠的。     

The development and initial validation of the Terminally Ill Grief or Depression Scale (TIGDS)

Patients often experience 'preparatory-grief' as they cope with the dying process. Some may be depressed. The Terminally Ill Grief or Depression Scale (TIGDS), comprising grief and depression sub-scales, is a new self-report measure designed to differentiate between preparatory-grief and depression in adult inpatients. The initial 100-item inventory was assembled based on literature review, interviews with clinicians and dying patients and then shortened to 42 items based on consensus expert opinion. Validity and reliability were tested in a sample of 55 terminally ill adults. The consensus clinical opinion was used as the gold standard to differentiate between preparatory grief and depression. The intra-class correlation coefficient was high (it was calculated to estimate the test-retest reliability for the 47 patients who had completed the TIGDS twice--retest was administered 2 to 7 days after the initial test), ranging from 0.86 (grief) to 0.97 (depression). The validity of TIGDS was assessed using a receiver operating characteristic curve analysis, comparing the first test with the clinical criterion. The first and only variable and cut-point was the depression score (chi-square = 18.4, p < 0.001, cut point = 3). The sensitivity of the TIGDS was 0.727 and specificity was 0.886 for the depression = 3 cutoff score. The construct validity of the TIGDS was tested by comparing with the Hospital Anxiety and Depression Scale (HADS). The TIGDS depression subscale showed strong convergent validity and the TIGDS grief subscale showed strong discriminant validity with the HADS total score.     

Psychometric properties of a Persian-language version of the Automatic Thoughts Questionnaire: ATQ-Persian

AIMS: To examine the psychometric properties of a Persian-language version of Hollon and Kendall's (1980) Automatic Thoughts Questionnaire (ATQ-Persian)--a measure of negative automatic thoughts in depression. METHODS: In a sample of 125 student volunteers from two Iranian universities we assessed the internal consistency and test-retest reliability of ATQ-Persian, and examined its concurrent validity against the Beck Depression Inventory (Beck et al., 1996). We also examined the factor structure of the test through comparing the fit of various proposed factor-analytic models to the data using confirmatory factor analysis. RESULTS: ATQ-Persian had excellent internal consistency (Cronbach's alpha = 0.96), test-retest reliability (r = 0.84) and correlation with the Beck Depression Inventory (r = 0.77). Using a receiver operating characteristics curve, a score of 53 on ATQ-Persian was associated with a sensitivity of 89% and a specificity of 78% for detecting moderate to severe depression defined through Beck Depression Inventory. None of the proposed factorial models fitted the data well. However, models with correlated factors generally provided better fit than models with orthogonal factors, suggesting that the latent factors underlying ATQ-Persian are highly correlated. CONCLUSIONS: These data support the reliability and validity of ATQ-Persian as a measure of negative automatic thoughts in depression.     

The Development and Standardization of a Spanish Version of the Washington Psychosocial Seizure Inventory

The Washington Psychosocial Seizure Inventory (WPSI) was translated from English into Spanish, reviewed by a bilingual panel, and then standardized on 107 Spanish-speakers and 45 bilinguals in Miami, Florida. The 152 subjects were active clients of the Epilepsy Foundation of South Florida. Subjects were assigned to one of three treatment groups: Monolingual (Spanish WPSI only), Bilingual (Spanish WPSI first), or Bilingual (English WPSI first). All three groups were given two administrations of the WPSI at least 30 days apart. Resulting data were submitted to measures of split-half reliability, test-retest reliability, and concurrent validity. The psychosocial scales were found to be internally consistent and showed stability across administrations with a marked similarity between the Spanish and English forms. The concurrent validity of the Spanish scales was established at the 0.01 level of significance or better. It was concluded that the Spanish WPSI was statistically comparable to the original English language version, thus establishing a basis for its usage in the psychological assessment of Spanish-speaking epileptics throughout the world.     

Reliability and validity of the self‐report version of the Panic Disorder Severity Scale in Korea

Background: The self‐report version of the Panic Disorder Severity Scale (PDSS‐SR) has been developed recently and has demonstrated good psychometric properties. However, there is no cross‐cultural evaluation of this scale. The purpose of this study was to confirm the reliability and validity of the PDSS‐SR in Korean subjects. Methods: We studied 148 patients with principal DSM‐IV diagnoses of panic disorder who underwent formal structured diagnostic assessment and the PDSS interview. The participants completed self‐report measures including the PDSS‐SR, Anxiety Sensitivity Index‐Revised, Albany Panic and Phobia Questionnaire, Beck Depression Inventory, Beck Anxiety Inventory, and Spielberger State–Trait Anxiety Inventory‐Trait Version. Results: The PDSS‐SR had a single‐factor structure, with all seven items having salient loadings. Cronbach's α for the PDSS‐SR was .88 and intraclass correlation coefficient was .71 between PDSS‐SR and PDSS. Also, the scale showed excellent 1‐day test–retest reliability and demonstrated significant correlation with other anxiety‐related measures. In addition, the PDSS‐SR was sensitive to change with pharmacological treatment. Conclusions: The findings of this study strongly support the reliability and validity of the PDSS‐SR. It is expected that this scale will be helpful in clinical settings and research protocols in Korea. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

A psychometric evaluation of a Chinese version of the Cardiac Depression Scale

OBJECTIVE: This study aimed to evaluate the validity, reliability, and cultural relevance of the Cardiac Depression Scale (CDS) as a disease-specific screening tool for Chinese cardiac patients. METHODS: The language equivalency and content validity of the Chinese version of the CDS (C-CDS) were evaluated. Measurement performance was tested on 200 Chinese cardiac patients and repeated on 40 patients for test-retest reliability. RESULTS: One item pertaining to sexual activity was removed from the Chinese version due to poor cultural relevance. The C-CDS demonstrated acceptable internal consistency (Cronbach's alpha of .91 for the total scale and .53-.78 for the subscales). The high correlation (r=.64-.89) between items and the remainder of their own scale provides further evidence of internal consistency. The test-retest reliability was satisfactory with intraclass correlation coefficients of .94 for the overall scale and .73-.92 for the six subscales. The total and subscale scores that were not significantly different (P>.05) over a 2-week period further support the stability of the instrument. There was acceptable concurrent validity with moderate (r>or=.3, P<.001) correlations between the C-CDS and the Chinese version of the Hospital Anxiety and Depression Scale. Principal component analysis revealed six factors, and one dimension was extracted from the data set, which closely resembles the structure of the original instrument. CONCLUSION: Empirical data support the C-CDS as a valid and reliable disease-specific tool in assessing depressed mood in Chinese-speaking patients with cardiac disease.     

Validation of the Chinese-Cantonese version of the hospital anxiety and depression scale and comparison with the Hamilton Rating Scale of Depression

OBJECTIVE: The aim of this study was to validate the Chinese-Cantonese version of the Hospital Anxiety and Depression Scale (HADS) and to compare it with the Hamilton Rating Scale of Depression (HRSD) as a screening tool for depressive disorders in general hospital in-patients. METHOD: The Chinese-Cantonese version of the HADS was administered to general hospital in-patients seen on a consultation basis, and psychiatric diagnoses were made according to DSM-III-R. The subjects were further rated independently with the HRSD. RESULTS: The Chinese-Cantonese version of the HADS was found to have good internal consistency and external validity, with favourable sensitivity and specificity for screening for psychiatric disorders. However, its performance was marginally inferior to that of the HRSD. The scale also performed poorly in identifying major depression. CONCLUSION: The HADS has limitations with regard to identification of depressive disorders. However, despite its shortcomings, it remains one of the best paper-and-pencil tests for screening psychiatric disorders in the medically ill.     

A psychometric evaluation of the Hospital Anxiety and Depression Scale for the medically hospitalized elderly

Background: Few psychometric studies of the Hospital Anxiety and Depression Scale (HADS) scale have been performed with clinical samples of elderly individuals. Methods: The participants were 484 elderly (65–101 years, 241 men) patients in an acute medical unit. The HADS, the Montgomery–Aasberg Depression Rating Scale (MADRS) and questionnaires assessing quality of life, functional impairment, and cognitive function were used. The psychometric evaluation of the HADS included the following analyses: 1) the internal construct validity by means of principal component analysis followed by an oblique rotation and corrected item–total correlation; 2) the internal consistency reliability by means of the alpha coefficient (Cronbach's) and 3) concurrent validity by means of Spearman's rho. Results: We found a two-factor solution explaining 45% of the variance. Six of seven items loaded adequately (≥0.40) on the HADS-A subscale (item 7 did not) and five of seven items loaded adequately on the HADS-D subscale (items 8 and 10 did not). Cronbach's alpha for the HADS-A and HADS-D subscale was 0.78 and 0.71, respectively. The correlation between HADS-D and the MADRS, a measure of the concurrent validity, was 0.51. Conclusion: The HADS appears to differentiate well between depression and anxiety. The internal consistency of the HADS in a sample of elderly persons was as satisfactory as it is in samples with younger persons. In contrast to younger samples, item 8 (“I feel as if I have slowed down”) did not load adequately on the HADS-D subscale. This may be attributed to the way elderly people experience and describe their symptoms.     

Reliability and validity of the Korean version of the Scale for the Assessment of Thought,Language, and Communication

BackgroundOur study aimed to assess the inter-rater and test-retest reliability, as well as concurrent and convergent validity, of the Korean version of the Scale for the Assessment of Thought, Language, and Communication (TLC scale).MethodsThe factor solutions and psychometric properties of the Korean version of the TLC scale were evaluated among 167 schizophrenia inpatients (study subjects) at two sites in South Korea. Using Pearson’s correlation, the concurrent and convergent validities of each of the factor solutions were represented by the correlations with the scores on the Clinical Language Disorder Rating Scale, Brief Psychiatric Rating Scale, Young Mania Rating Scale, and Calgary Depression Scale. Using receiver operating characteristics curves, the optimal cut-off score for the Korean version of the TLC scale to distinguish between study subjects with and without disorganized speech, was identified.ResultsThe results showed that the Korean version of the TLC scale has a three-factor solution: fluent disorganization, speech emptiness, and speech peculiarity. In addition, the interrater reliability of the Korean version of the TLC scale was moderately good (intraclass correlation coefficient = 0.51) and its test-retest reliability was very good (Pearson’s correlation coefficient = 0.94). For detecting the current presence of disorganized speech, the optimal cut-off total score on the TLC scale was proposed to be 8 points (sensitivity = 88.1%; specificity = 82.9%).LimitationsPsychometric tools covering cognitive functions were not used in our study.ConclusionsThe Korean version of the TLC scale is a promising psychometric method for examining formal thought disorder (FTD) and disorganized speech in schizophrenia patients.     

Psychometric properties of the Spanish version of the Obsessive-Compulsive Inventory--revised in a non-clinical sample

The psychometric properties of a Spanish version of the Obsessive-Compulsive Inventory-Revised (OCI-R) were examined in a non-clinical student sample (n=381). A confirmatory factor analysis replicated the original six-factor structure. The total and each of the subscales of the Spanish OCI-R demonstrated moderate to good internal consistency and test-retest reliability, moderate convergent validity and good divergent validity. The Spanish version of the OCI-R retains the sound psychometric properties of the original version.     

A new validation of the Hamilton Rating Scale for Depression

This paper investigates the reliability and validity of a Spanish version of the Hamilton Rating Scale for Depression (17-item version) which has good concurrent (r = 0.82) and content (average frequency = 62%) validity. Inter-rater reliability (r = 0.99), split-half reliability (r = 0.89) and alpha reliability (r = 0.72) are acceptable. A Factor Analysis identified five factors accounting for 56% of total variance.     

Reliability and Validity of the Korean Version of the Modified Adult Attachment Scale for the Use of Medically Ill Patients

Objective

The Modified Experiences in Close Relationships (ECR-M36) scale was developed for medically ill, older individuals in 2008 (Toronto, Canada, department of psychosocial oncology and palliative care, Princess Margaret Hospital). The scale has displayed satisfactory reliability and validity. This study aimed to test the reliability and validity of the Korean version of Modified Experiences in Close Relationships (K-ECR-M36) questionnaire in female patients with breast cancer.

Methods

A total of 199 post-operative breast cancer patients completed the K-ECR-M36 as well as other psychological measures including the Revised Adult Attachment Scale (RAAS), World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), and Hospital Anxiety and Depression Scale (HADS). The reliability and validity of the K-ECR-M36 were evaluated. Explorative factor analysis was conducted to identify the factor structure of the K-ECR-M36.

Results

The K-ECR-M36 showed good internal consistency (Cronbach''s α=0.87) and reasonable test-retest reliability (r=0.752, p<0.001). The total as well as avoidance and anxiety subscales demonstrated construct validity with the RAAS, the HADS, and the WHOQOL-BREF. Factor analysis revealed four-factor structure which was originally proposed by Brennan, Clark, and Shaver (1998).

Conclusion

These findings support that the K-ECR-M36 has satisfactory reliability, validity and factor structure among patients with breast cancer.     

Standardization of the Korean Version of the Geriatric Depression Scale: Reliability, Validity, and Factor Structure

Objective

We developed a Revised Korean version of the Geriatric Depression Scale (GDS-KR) and examined its reliability, validity, and factor structures. We also estimated its optimal cutoff scores for major depressive disorder (MDD) and minor depressive disorder (MnDD) stratified by age and education.

Methods

The GDS-KR was administered to 888 subjects (61 MDD patients, 45 MnDD patients, and 782 normal elders). Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D-K) and Hamilton Depression Rating Scale (HAM-D). The mean GDS-KR scores of the MDD patients, MnDD patients and normal elders were compared to evaluate its discriminant validity. To evaluate its construct validity, a principal component analysis with varimax rotation was performed. Receiver operator characteristic (ROC) curve analyses were performed to evaluate its diagnostic ability.

Results

Chronbach''s coefficient alpha for the GDS-KR was 0.90 and the test-retest reliability was 0.91 (p<0.01). The Pearson correlation coefficients of the GDS-KR scores with the CES-D-K and HAM-D scores were 0.63 (p<0.01) and 0.56 (p<0.01), respectively. The GDS-KR consisted of 5 factors. The optimal cut-off scores of the GDS-KR were 16/17 for MDD only and 15/16 for both MDD and MnDD. The optimal cutoff scores of the GDS-KR were higher in the less educated and younger subjects. The diagnostic accuracy for MDD of the GDS-KR was higher than that of the CES-D.

Conclusion

The GDS-KR was found to be a reliable and valid questionnaire for screening MDD and MnDD in late life.