The Psychometric Properties of the Center for Epidemiologic Studies Depression Scale in Chinese Primary Care Patients: Factor Structure, Construct Validity, Reliability, Sensitivity and Responsiveness.
The Psychometric Properties of the Center for Epidemiologic Studies Depression Scale in Chinese Primary Care Patients: Factor Structure, Construct Validity, Reliability, Sensitivity and Responsiveness.
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DOI：
10.1371/journal.pone.0135131
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Wong CK
中科院分区：
文献类型：
--
作者：
Chin WY;Choi EP;Chan KT;Wong CK
流行病学研究中心抑郁量表（CES-D）是一种常用的工具来测量抑郁症。尽管如此，在中国人群中，其心理测量学特性的证据仍然很难建立。本研究的目的是验证使用的CES-D在中国初级保健患者的因素结构，结构效度，信度，敏感性和反应性。在香港的3686名中国成年初级保健患者的样本中进行了心理测量学评估。三个竞争因素结构模型进行了验证性因素分析。原始CES-D四结构模型具有足够的拟合度，但数据更适合双因素模型。对于内部结构效度，校正项目总相关系数为0.4的大多数项目。通过检查CES-D、患者健康问卷9（PHQ-9）和简明健康调查表（SF-12 v2 MCS）之间的相关性来评估收敛效度。CES-D与PHQ-9（系数：0.78）和SF-12 v2 MCS（系数：-0.75）具有强相关性。内部一致性采用McDonald's omega hierarchical（ωH）进行评价。一般抑郁因子的ωH值为0.855。躯体化、抑郁情绪、积极情绪和人际问题的ωH值分别为0.434、0.038、0.738和0.730。对于两周的重测信度，组内相关系数为0.91。CES-D在检测已知组之间的差异方面是敏感的，AUC >0.7。CES-D检测阳性和阴性变化的内部响应性令人满意（p值<0.01 and all effect size statistics >0.2）。CES-D具有外部响应性，AUC>0.7。CES-D是一种有效、可靠、敏感和反应灵敏的工具，可用于筛查和监测中国成人初级保健患者的抑郁症状。在其原始的四因素和双因素结构中，CES-D支持多中心研究中抑郁症的跨文化比较。
The Center for Epidemiologic Studies Depression Scale (CES-D) is a commonly used instrument to measure depressive symptomatology. Despite this, the evidence for its psychometric properties remains poorly established in Chinese populations. The aim of this study was to validate the use of the CES-D in Chinese primary care patients by examining factor structure, construct validity, reliability, sensitivity and responsiveness. The psychometric properties were assessed amongst a sample of 3686 Chinese adult primary care patients in Hong Kong. Three competing factor structure models were examined using confirmatory factor analysis. The original CES-D four-structure model had adequate fit, however the data was better fit into a bi-factor model. For the internal construct validity, corrected item-total correlations were 0.4 for most items. The convergent validity was assessed by examining the correlations between the CES-D, the Patient Health Questionnaire 9 (PHQ-9) and the Short Form-12 Health Survey (version 2) Mental Component Summary (SF-12 v2 MCS). The CES-D had a strong correlation with the PHQ-9 (coefficient: 0.78) and SF-12 v2 MCS (coefficient: -0.75). Internal consistency was assessed by McDonald’s omega hierarchical (ωH). The ωH value for the general depression factor was 0.855. The ωH values for “somatic”, “depressed affect”, “positive affect” and “interpersonal problems” were 0.434, 0.038, 0.738 and 0.730, respectively. For the two-week test-retest reliability, the intraclass correlation coefficient was 0.91. The CES-D was sensitive in detecting differences between known groups, with the AUC >0.7. Internal responsiveness of the CES-D to detect positive and negative changes was satisfactory (with p value <0.01 and all effect size statistics >0.2). The CES-D was externally responsive, with the AUC>0.7. The CES-D appears to be a valid, reliable, sensitive and responsive instrument for screening and monitoring depressive symptoms in adult Chinese primary care patients. In its original four-factor and bi-factor structure, the CES-D is supported for cross-cultural comparisons of depression in multi-center studies.