Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa

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dc.contributor.authorBaron, Emily Claire
dc.contributor.authorDavies, Thandi
dc.contributor.authorLund, Crick
dc.date.accessioned2021-10-08T06:54:47Z
dc.date.available2021-10-08T06:54:47Z
dc.date.issued2017
dc.description.abstractAbstract Background The 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) is a depression screening tool that has been used in the South African National Income Dynamics Study (NIDS), a national household panel study. This screening tool has not yet been validated in South Africa. This study aimed to establish the reliability and validity of the CES-D-10 in Zulu, Xhosa and Afrikaans. The CES-D-10’s psychometric properties were also compared to the Patient Health Questionnaire (PHQ-9), a depression screening tool already validated in South Africa. Methods Stratified random samples of Xhosa, Afrikaans and Zulu-speaking participants aged 15 years or older (N = 944) were recruited from Cape Town Metro and Ethekwini districts. Face-to-face interviews included socio-demographic questions, the CES-D-10, Patient Health Questionnaire (PHQ-9), and WHO Disability Assessment Schedule 2.0 (WHODAS). Major depression was determined using the Mini International Neuropsychiatric Interview. All instruments were translated and back-translated to English. Construct validity was examined using exploratory factor analysis with varimax rotation. Receiver Operating Characteristics (ROC) curves were used to investigate the CES-D-10 and PHQ-9’s criterion validity, and compared using the DeLong method. Results Overall, 6.6, 18.0 and 6.9% of the Zulu, Afrikaans and Xhosa samples were diagnosed with depression, respectively. The CES-D-10 had acceptable internal consistency across samples (α = 0.69–0.89), and adequate concurrent validity, when compared to the PHQ-9 and WHODAS. The CES-D-10 area under the Receiver Operator Characteristic curve was good to excellent: 0.81 (95% CI 0.71–0.90) for Zulu, 0.93 (95% CI 0.90–0.96) for Afrikaans, and 0.94 (95% CI 0.89–0.99) for Xhosa. A cut-off of 12, 11 and 13 for Zulu, Afrikaans and Xhosa, respectively, generated the most balanced sensitivity, specificity and positive predictive value (Zulu: 71.4, 72.6% and 16.1%; Afrikaans: 84.6%, 84.0%, 53.7%; Xhosa: 81.0%, 95.0%, 54.8%). These were slightly higher than those generated for the PHQ-9. The CES-D-10 and PHQ-9 otherwise performed similarly across samples. Conclusions The CES-D-10 is a valid, reliable screening tool for depression in Zulu, Xhosa and coloured Afrikaans populations.
dc.identifier.apacitationBaron, E. C., Davies, T., & Lund, C. (2017). Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. <i>BMC Psychiatry</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34341en_ZA
dc.identifier.chicagocitationBaron, Emily Claire, Thandi Davies, and Crick Lund "Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa." <i>BMC Psychiatry</i> 17, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34341en_ZA
dc.identifier.citationBaron, E.C., Davies, T. & Lund, C. 2017. Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. <i>BMC Psychiatry.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34341en_ZA
dc.identifier.issn1471-244X
dc.identifier.ris TY - Journal Article AU - Baron, Emily Claire AU - Davies, Thandi AU - Lund, Crick AB - Abstract Background The 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) is a depression screening tool that has been used in the South African National Income Dynamics Study (NIDS), a national household panel study. This screening tool has not yet been validated in South Africa. This study aimed to establish the reliability and validity of the CES-D-10 in Zulu, Xhosa and Afrikaans. The CES-D-10’s psychometric properties were also compared to the Patient Health Questionnaire (PHQ-9), a depression screening tool already validated in South Africa. Methods Stratified random samples of Xhosa, Afrikaans and Zulu-speaking participants aged 15 years or older (N = 944) were recruited from Cape Town Metro and Ethekwini districts. Face-to-face interviews included socio-demographic questions, the CES-D-10, Patient Health Questionnaire (PHQ-9), and WHO Disability Assessment Schedule 2.0 (WHODAS). Major depression was determined using the Mini International Neuropsychiatric Interview. All instruments were translated and back-translated to English. Construct validity was examined using exploratory factor analysis with varimax rotation. Receiver Operating Characteristics (ROC) curves were used to investigate the CES-D-10 and PHQ-9’s criterion validity, and compared using the DeLong method. Results Overall, 6.6, 18.0 and 6.9% of the Zulu, Afrikaans and Xhosa samples were diagnosed with depression, respectively. The CES-D-10 had acceptable internal consistency across samples (α = 0.69–0.89), and adequate concurrent validity, when compared to the PHQ-9 and WHODAS. The CES-D-10 area under the Receiver Operator Characteristic curve was good to excellent: 0.81 (95% CI 0.71–0.90) for Zulu, 0.93 (95% CI 0.90–0.96) for Afrikaans, and 0.94 (95% CI 0.89–0.99) for Xhosa. A cut-off of 12, 11 and 13 for Zulu, Afrikaans and Xhosa, respectively, generated the most balanced sensitivity, specificity and positive predictive value (Zulu: 71.4, 72.6% and 16.1%; Afrikaans: 84.6%, 84.0%, 53.7%; Xhosa: 81.0%, 95.0%, 54.8%). These were slightly higher than those generated for the PHQ-9. The CES-D-10 and PHQ-9 otherwise performed similarly across samples. Conclusions The CES-D-10 is a valid, reliable screening tool for depression in Zulu, Xhosa and coloured Afrikaans populations. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Psychiatry LK - https://open.uct.ac.za PY - 2017 SM - 1471-244X T1 - Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa TI - Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa UR - http://hdl.handle.net/11427/34341 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34341
dc.identifier.vancouvercitationBaron EC, Davies T, Lund C. Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. BMC Psychiatry. 2017;17(1):174 - 177. http://hdl.handle.net/11427/34341.en_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Health
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC Psychiatry
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12888-016-1178-x
dc.subject.otherCES-D-10
dc.subject.otherDepression
dc.subject.otherPHQ-9
dc.subject.otherPrevalence
dc.subject.otherScreening
dc.subject.otherSouth Africa
dc.subject.otherValidation
dc.subject.otherAdolescent
dc.subject.otherAdult
dc.subject.otherAged
dc.subject.otherDepression
dc.subject.otherDepressive Disorder, Major
dc.subject.otherFactor Analysis, Statistical
dc.subject.otherFemale
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherMass Screening
dc.subject.otherMiddle Aged
dc.subject.otherPsychiatric Status Rating Scales
dc.subject.otherPsychometrics
dc.subject.otherReproducibility of Results
dc.subject.otherSensitivity and Specificity
dc.subject.otherSouth Africa
dc.titleValidation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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