The Depression Scale (DEPS) is a commonly used screening tool for major depression in studies investigating low back pain, yet it has not been validated for patients with back-specific problems.
OBJECTIVE:
To assess the psychometric properties of the DEPS in patients with degenerative spinal disease.
METHODS:
Six hundred and thirty-seven patients with a degenerative spinal disease completed the DEPS instrument. The Rasch Measurement Theory was applied to analyze the measurement properties of the DEPS. The main hypothesis-driven approach was whether the DEPS would meet relevant psychometric criteria for assessing depressive symptoms among patients with degenerative spinal disease.
RESULTS:
The Mean (SD) DEPS score was 9.2 (6.6). Scale minimum or maximum points among participants were 2.4% and 0.8%, respectively. Cronbach’s alpha for internal consistency was 0.92. Person Separation Index for reliability was 0.88. All items had ordered thresholds and seven of the 10 items had good item fit. Unidimensionality of the DEPS was supported (proportion of significant -tests, 4.5%).
CONCLUSIONS:
This study supports the validity of the DEPS for screening depressive symptoms in patients with degenerative spinal disease.
AnderssonGBJ. Epidemiological features of chronic low-back pain. The Lancet.1999; 354(9178): 581-585.
2.
AnderssonGB. Epidemiology of low back pain. Acta Orthopaedica Scandinavica.1998; 69(sup281): 28-31.
3.
HartvigsenJHancockMJKongstedA, et al. What low back pain is and why we need to pay attention. The Lancet.2018.
4.
BairMJRobinsonRLKatonWKroenkeK. Depression and pain comorbidity: a literature review. Archives of internal medicine.2003; 163(20): 2433-2445.
5.
PolatinPBKinneyRKGatchelRJLilloEMayerTG. Psychiatric illness and chronic low-back pain. The mind and the spine-which goes first? Spine.1993; 18(1): 66-71.
6.
TuomainenIPakarinenMAaltoT, et al. Depression is associated with the long-term outcome of lumbar spinal stenosis surgery: a 10-year follow-up study. The Spine Journal.2018; 18(3): 458-463.
7.
WahlmanMHäkkinenADekkerJMarttinenIVihtonenKNevaMH. The prevalence of depressive symptoms before and after surgery and its association with disability in patients undergoing lumbar spinal fusion. European Spine Journal.2014; 23(1): 129-134.
8.
GuyattGCairnsJChurchillD, et al. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA.1992; 268(17): 2420-2425.
9.
GuyattGHKirshnerBJaeschkeR. Measuring health status: what are the necessary measurement properties? Journal of Clinical Epidemiology.1992; 45(12): 1341-1345.
10.
MarshallSHaywoodKFitzpatrickR. Impact of patient-reported outcome measures on routine practice: a structured review. Journal of Evaluation in Clinical Practice.2006; 12(5): 559-568.
11.
DawsonJDollHFitzpatrickRJenkinsonCCarrAJ. The routine use of patient reported outcome measures in healthcare settings. BMJ (Clinical Research Ed).2010; 340: c186.
12.
BlackN. Patient reported outcome measures could help transform healthcare. BMJ (Clinical Research Ed).2013; 346: f167.
13.
DworkinRHTurkDCFarrarJT, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain.2005; 113(1): 9-19.
14.
PanayidesPRobinsonCTymmsP. The assessment revolution that has passed England by: rasch measurement. British Educational Research Journal.2010; 36(4): 611-626.
15.
RaschG. Probabilistic Models for Some Intelligence and Attainment Tests. Danish Institute for Education Research, reprinted: MESA Press; 1993.
16.
SalokangasRKPoutanenOStengardE. Screening for depression in primary care. Development and validation of the Depression Scale, a screening instrument for depression. Acta Psychiatrica Scandinavica.1995; 92(1): 10-16.
17.
PaykelEPriestR. Recognition and management of depression in general practice: consensus statement. BMJ: British Medical Journal.1992; 305(6863): 1198.
18.
PoutanenOKoivistoAMSalokangasRK. The Depression Scale (DEPS) as a case finder for depression in various subgroups of primary care patients. European Psychiatry: The Journal of the Association of European Psychiatrists.2008; 23(8): 580-586.
19.
BeckATBeamesderferA. Assessment of depression: the depression inventory. Psychological measurements in psychopharmacology. Vol 7: Karger Publishers; 1974: 151-169.
20.
BeckATWardCHMendelsonMMockJErbaughJ. An inventory for measuring depression. Archives of General Psychiatry.1961; 4(6): 561-571.
21.
BeckATSteerRA. Internal consistencies of the original and revised beck depression inventory. Journal of Clinical Psychology.1984; 40(6): 1365-1367.
22.
PoutanenOKoivistoAMSalokangasRK. Applicability of the DEPS Depression Scale: assessing format and individual items in subgroups of patients. Nordic Journal of Psychiatry.2010; 64(6): 384-390.
23.
NiemistöLLahtinen-SuopankiTRissanenPLindgrenK-ASarnaSHurriH. A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for chronic low back pain. Spine.2003; 28(19): 2185-2191.
24.
KääpäEHFrantsiKSarnaSMalmivaaraA. Multidisciplinary group rehabilitation versus individual physiotherapy for chronic nonspecific low back pain: a randomized trial. Spine.2006; 31(4): 371-376.
25.
LehtolaVLuomajokiHLeinonenVGibbonsSAiraksinenO. Efficacy of movement control exercises versus general exercises on recurrent sub-acute nonspecific low back pain in a sub-group of patients with movement control dysfunction. Protocol of a randomized controlled trial. BMC Musculoskeletal Disorders.2012; 13(1): 55.
26.
FairbankJCPynsentPB. The oswestry disability index. Spine (Phila Pa 1976).2000; 25(22): 2940-2952; discussion 2952.
27.
HuskissonEC. Measurement of pain. Lancet.1974; 2(7889): 1127-1131.
28.
PriceDDMcGrathPARafiiABuckinghamB. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain.1983; 17(1): 45-56.
29.
PoutanenOKoivistoA-MKääriäSSalokangasRKR. The validity of the Depression Scale (DEPS) to assess the severity of depression in primary care patients. Family Practice.2010; 27(5): 527-534.
30.
TennantAConaghan PhilipG. The rasch measurement model in rheumatology: what is it and why use it? When should it be applied, and what should one look for in a rasch paper? Arthritis Care & Research.2007; 57(8): 1358-1362.
31.
TesioL. Measuring behaviours and perceptions: rasch analysis as a tool for rehabilitation research. [Erratum appears in J Rehabil Med. 2003; Nov; 35(6): 294]. Journal of Rehabilitation Medicine.35(3): 105-115.
32.
ElhanAKüçükdeveciATennantA. The Rasch measurement model. Research Issues in physical and rehabilitation Medicine.2010: 89-102.
33.
HobartJCCanoSJZajicekJPThompsonAJ. Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations. The Lancet Neurology.2007; 6(12): 1094-1105.
34.
BondTGFoxCM. Applying the Rasch model: Fundamental measurement in the human sciences, 2nd ed. Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers; 2007.
35.
HagquistCBruceMGustavssonJP. Using the Rasch model in nursing research: an introduction and illustrative example. International Journal of Nursing Studies.2009; 46(3): 380-393.
36.
HobartJCanoS. Improving the evaluation of therapeutic interventions in multiple sclerosis: the role of new psychometric methods. Prepress Projects; 2009.
37.
WrightBDStoneMH. Reliability in Rasch measurement.: Wilmington (DE): Wire Range INC; 1999.
38.
CronbachLJMeehlPE. Construct validity in psychological tests. Psychological Bulletin.1955; 52(4): 281.
39.
SullivanMJLReesorKMikailSFisherR. The treatment of depression in chronic low back pain: review and recommendations. Pain.1992; 50(1): 5-13.
40.
RomanoJMTurnerJA. Chronic pain and depression: does the evidence support a relationship? Psychological bulletin.1985; 97(1): 18.
41.
Von KorffMRescheLLDworkinSF. First onset of common pain symptoms: a prospective study of depression as a risk factor. Pain.1993; 55(2): 251-258.
42.
SalokangasRKRVaahteraKPacrievSSohlmanBLehtinenV. Gender differences in depressive symptoms: an artefact caused by measurement instruments? Journal of Affective Disorders.2002; 68(2): 215-220.
43.
PallantJFTennantA. An introduction to the rasch measurement model: an example using the hospital anxiety and depression scale (HADS). British Journal of Clinical Psychology.2007; 46: 1-18.
44.
GilbodySHouseASheldonT. Screening and case finding instruments for depression. Cochrane Database of Systematic Reviews. 2005(4).
