Depression is a major disorder that can be ttriggering, exacerbating, or co-occurring with dementia symptoms. Its assessment is paramount to achieve diagnostic, prognostic, and therapeutic decisions. The Cornell Scale for Depression in Dementia (CSDD) is purposely designed to address clinically this issue.
Objective:
To examine the reliability and validity of an Arabic version of the CSDD (A-CSDD) in the Tunisian population.
Methods:
Fifty-seven participants took part in this study: 20 as a control group (NC), 18 as dementia patients with depression (DD), and 19 as depressed patients without dementia (DND); all patients met the DSM IV criteria for depression and/or dementia. A translated, back-translated and adapted Arabic version of the CSDD was administered in parallel with the Geriatric Depression Scale (GDS), the non-cognitive part of the Alzheimer’s disease Assessment Scale, and the Mini-Mental State Examination.
Results:
The A-CSDD had good internal consistency (Cronbach’s alpha = 0.85) and high test-retest reliability (Rho = 0.897, p < 0.001). The A-CSDD had excellent discriminatory power to diagnose depression in dementia patients (AUC = 0.90, p < 0.001) and good concurrent validity with the GDS (Rho = 0.70, p < 0.001). A principal component analysis with varimax rotation, performed on the DD group, led to a configuration of five factors explaining 75% of the variance.
Conclusions:
The results showed that this Arabic-Tunisian version of the A-CSDD is reliable and valid for diagnosing depression in an elderly Tunisian population with dementia and can be used in clinical and research settings.
BenedictKB, NacosteDB (1990) Dementia and depression: A framework for addressing difficulties in differential diagnosis. Clin Psychol Rev10, 523–537.
2.
WellsKB, StewartA, HaysRD, BurnamMA, RogersW, DanielsM, BerryS, GreenfieldS, WareJ (1989) The functioning and well-being of depressed patients. JAMA262, 914–9.
3.
PenninxBW, GeerlingsSW, DeegDJ, EijkJT, TilburgW, BeekmanAT (1999) Minor and major depression and the risk of death in older persons. Arch Gen Psychiatry56, 889–95.
4.
KatonaC, FreelingP, HinchcliffeK, BlanchardM, WrightA (1995) Recognition and management of depression in late life in general practice. Consensus statement. Prim Care Psychiat1, 107–113.
5.
KørnerA, LauritzenL, AbelskovK, GulmannN, Marie BrodersenA, Wedervang-JensenT, Marie KjeldgaardK (2006) The Geriatric Depression Scale and the Cornell Scale for Depression in Dementia. A validity study. Nord J Psychiatry60, 360–364.
6.
KorczynAD, HalperinI (2009) Depression and dementia. J Neurol Sci283, 139–142.
7.
OhannaI, GolanderH, BarakY (2011) Does late onset depression predispose to dementia? A retrospective, case-controlled study. Compr Psychiatry52, 659–61.
LyketsosCG, DelCampoL, SteinbergM, MilesQ, SteeleCD, MunroC, BakerAS, SheppardJM, FrangakisC, BrandtJ, RabinsPV (2003) Treating depression in Alzheimer disease: Efficacy and safety of sertraline therapy, and benefits of depression reduction: The DIADS. Arch Gen Psychiatry60, 737–746.
10.
LyketsosCG, OlinJ (2002) Depression in Alzheimer’s disease: Overview and treatment. Biol Psychiatry52, 243–252.
11.
LandrevilleP, RousseauF, VezinaJ, VoyerP (2005) Symptômes comportementaux et psychologiques de la démence, Edisem/Maloine, Québec.
12.
RobertIP, DavidR (2015) Symptômes psychologiques et comportementaux liés aux démences. In Démences, DuboisB, MichonA, eds. DOIN, Paris, pp. 66–72.
13.
BurnsA, JacobyR, LevyR (1990) Psychiatric phenomena in Alzheimer’s disease. III: Disorders of mood. Br J Psychiatry157, 81–84.
14.
LyketsosCG, LeeHB (2004) Diagnosis and treatment of depression in Alzheimer’s disease: A practical update for the clinician. Dement Geriatr Cogn Disord17, 55–64.
15.
SadockBJ, SadockVA (2005) Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 8th ed., Lippincott Williams & Wilkins, Philadelphia.
16.
TatschMF, BottinoCM, AzevedoD, HototianSR, MoscosoMA, FolquittoJC, ScalcoAZ, LouzãMR (2006) Neuropsychiatric symptoms in Alzheimer disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: Prevalence and relationship with dementia severity. Am J Geriatr Psychiatry14, 438–445.
17.
KalesHC, ChenP, BlowFC, WelshDE, MellowAM (2005) Rates of clinical depression diagnosis, functional impairment, and nursing home placement in coexisting dementia and depression. Am J Geriatr Psychiatry13, 441–449.
18.
ShimYS, YangDW (2006) Depression as prognostic factor: 6 months follow-up in a geriatric institution. Arch Gerontol Geriatr43, 277–283.
19.
AlexopoulosGS, AbramsRC, YoungRC, ShamoianChA (1988) Cornell Scale for Depression in Dementia. Biol Psychiatry23, 271–284.
20.
LamCK, LimPPJ, LowBL, NgL-L, ChiamPC, SahadevanS (2004) Depression in dementia: A comparative and validation study of four brief scales in the elderly Chinese. Int J Geriatr Psychiatry19, 422–428.
21.
Müller-ThomsenT, ArltS, MannU, MaßR, GanzerS (2005) Detecting depression in Alzheimer’s disease: Evaluation of four different scales. Arch Clin Neuropsychol20, 271–276.
22.
LimPA, De SilvaDA, NgYS (2003) Depression assessment in rehabilitation patients with communication difficulties: The Cornell Depression Scale. Arch Phys Med Rehabil84, E33.
23.
AlexopoulosGS, AbramsRC, YoungRC, ShamoianChA (1988) Use of the Cornell Scale in non-demented patients. J Am Geriatr Soc36, 230–236.
24.
AdamsRL, BoakeC, CrainC (1982) Bias in a neuropsychological test classification related to education, age, and ethnicity. J Consult Clin Psychol50, 143–145.
25.
OwnbyRL, HarwoodDG, AcevedoA, BarkerW, DuaraR (2001) Factor structure of the Cornell Scale for Depression in Dementia for Anglo and Hispanic patients with dementia. Am J Geriatr Psychiatry9, 217–224.
26.
CamusV, SchmittL, OussetPJ, MicasM (1995) Depression and dementia: Contribution to the French validation of 2 depression scales: The Cornell Scale for Depression in Dementia and the Dementia Mood Assessment Scale. Encéphale21, 201–208.
27.
Pujol-DoménechJ, De AzpiazuP, SalameroM, CuevasR (2001) Depressive symptoms in dementia: The Cornell Scale. Validation of the Spanish Version. Rev Neurol33, 397–398.
28.
SchreinerAS, HayakawaH, MorimotoT, KakumaT (2003) Screening for late life depression: Cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects. Int J Geriatr Psychiatry18, 498–505.
29.
AmukT, KaradağF, OğuzhanoğluN, OğuzhanoğluA (2003) Reliability and validity of the Cornell Scale for Depression in Dementia in an elderly Turkish population. Turk Psikiyatri Dergisi14, 263–271.
30.
Carthery-GoulartMT, Areza-FegyveresR, SchultzRR, OkamotoI, CaramelliP, BertolucciPH, NitriniR (2007) Brazilian version of the Cornell depression scale in dementia. Arq Neuropsiquiatr65 (3B), 912–915.
31.
LimHK, HongSC, WonWY, HahnC, LeeCU (2012) Reliability and validity of the Korean version of the Cornell Scale for Depression in Dementia. Psychiatry Investig9, 332–338.
32.
WongpakaranN, WongpakaranT (2013) Cornell Scale for Depression in Dementia: Study of residents in a northern Thai long-term care home. Psychiatry Investig10, 359–364.
33.
PolitisA, MaillisA, ThomadakiO, PassaM, StamouliE, KotrotsouM, KontoaggellosK, SoldatosC (2006) Validity and reliability of the newly translated Cornell Scale for Depression in Dementia (CSDD) applied to Greek outpatients with depression and depression and Alzheimer’s disease. Ann Gen Psychiatry5(Suppl 1), S245.
34.
RomdhaneMN, BellajT, Attia RomdhaneN (2008) Comment sont adaptés et validés les tests neuropsychologiques en Tunisie. Tunis Med86, 746–753.
35.
KaramGE, KhandakjiMN, Sarkis SahakianN, DandanJC, KaramEG (2018) Validation of geriatric depression and anxiety rating scales into Arabic. Alzheimers Dement (Amst)10, 791–795.
36.
MessariN (2011) Au-delà des clichés: Différences et similarités entre les pays arabes. Cult Confl83, 113–117.
37.
FernándezAL, MarcopulosBA (2008) A comparison of normative data for the Trail Making Test from several countries: Equivalence of norms and considerations for interpretation. Scand J Psychol49, 239–246.
38.
American Psychiatric Association (1994) DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. APA, Washington.
39.
Van de VijverFJR, HambletonPM (1996) Translating tests: Some practical guidelines. Eur Psychol1, 89–99.
40.
BellajT, Ben JemaaS, AnaneN, Attia-RomdhaneN, Ben YoussefK, KahouajiH, BouazizM, MrabetA (2008) Version arabe de la Geriatric Depression Scale (A-GDS): Fidélité, validité et données normatives. Tunis Med86, 801–808.
41.
RosenWG, MohsRC, DavisKL (1984) A new rating scale for Alzheimer’s disease. Am J Psychiatry141, 1356–1364.
42.
FolsteinMF, FolsteinSE, McHughPR (1975) “Mini-mental State”: A practical method for grading the cognitive status of patients for the clinician. J Psychiatr Res12, 189–198.
43.
BellajT, Ben JemaaS, Attia-RomdhaneN, DhiffallahM, Ben AliN, BouazizM, MrabetA (2008) Version arabe du Mini Mental State Examination (A-MMSE): Fidélité, validité et données normatives. Tunis Med86, 768–776.
44.
IBM Corp (2016) IBM SPSS Statistics for Windows, version 23, IBM Corp., Armonk, NY.
45.
RabinsteinAA, ShulmanLM (2001) Management of behavioral and psychiatric problems in Parkinson’s disease. Parkinsonism Relat Disord7, 41–50.
46.
SchneiderLS, DagermanKS (2004) Psychosis of Alzheimer’s disease: Clinical characteristics and history. J Psychiatr Res38, 105–111.
McKeithI, CummingsJ (2005) Behavioural changes and psychological symptoms in dementia disorders. Lancet Neurol4, 735–742.
49.
SchreinerAS, MorimotoT (2002) Factor structure of the Cornell Scale for Depression in Dementia among Japanese poststroke patients. Int J Geriatr Psychiatry17, 715–722.
50.
BorzaT, EngedalK, BerghS, BarcaML, BenthJŠ, SelbækG (2015) The course of depressive symptoms as measured by the Cornell scale for depression in dementia over 74 months in 1158 nursing home residents. J Affect Disord175, 209–216.
51.
LinJ-N, WangJ-J (2008) Psychometric evaluation of the Chinese version of the Cornell Scale for Depression in Dementia. J Nurs Res16(3), 202–210.
52.
VidaS, Des RosiersP, CarrierL, GauthierS (1994) Depression in Alzheimer’s disease: Receiver operating characteristic analysis of the Cornell Scale for Depression in Dementia and the Hamilton Depression Scale. J Geriatr Psychiatry Neurol7, 159–162.
53.
BarcaML, EngedalK, SelbækG (2010) A reliability and validity study of the Cornell Scale among elderly inpatients, using various clinical criteria. Dement Geriatr Cogn Disord29, 438–447.
54.
HarwoodDG, OwnbyRL, BarkerWW, DuaraR (1998) The factor structure of the Cornell Scale for Depression in Dementia among probable Alzheimer’s disease patients. Am J Geriatr Psychiatry6, 212–220.
55.
BarcaML, EngedalK, SelbaekG, KnapskogAB, LaksJ, CoutinhoE, BenthJŠ (2015) Confirmatory factor analysis of the Cornell scale for depression in dementia among patient with dementia of various degrees. J Affect Disord188, 173–178.
