Validating the Center for Epidemiological Studies Depression Scale for Children in Rwanda - 29/11/12
, Pamela Scorza, M.P.H. b, Sarah Meyers-Ohki, B.A. c, Christina Mushashi, B.A. c, d, Yvonne Kayiteshonga, Ph.D. e, Agnes Binagwaho, M.D. g, Sara Stulac, M.D., M.P.H. f, William R. Beardslee, M.D. g
Correspondence to Theresa Betancourt, Sc.D., M.A., Associate Professor of Child Health and Human Rights in the Department of Global Health and Population and Director of the Research Program on Children and Global Adversity (RPCGA) at the François-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health, 651 Huntington Avenue, 7th floor, Boston, MA 02115Résumé |
Objective |
We assessed the validity of the Center for Epidemiological Studies Depression Scale for Children (CES-DC) as a screen for depression in Rwandan children and adolescents. Although the CES-DC is widely used for depression screening in high-income countries, its validity in low-income and culturally diverse settings, including sub-Saharan Africa, is unknown.
Method |
The CES-DC was selected based on alignment with local expressions of depression-like problems in Rwandan children and adolescents. To examine criterion validity, we compared CES-DC scores to depression diagnoses on a structured diagnostic interview, the Mini International Neuropsychiatric Interview for Children (MINI KID), in a sample of 367 Rwandan children and adolescents aged 10 through 17 years. Caregiver and child or adolescent self-reports endorsing the presence of local depression-like problems agahinda kenshi (persistent sorrow) and kwiheba (severe hopelessness) were also examined for agreement with MINI KID diagnosis.
Results |
The CES-DC exhibited good internal reliability (α = .86) and test-retest reliability (r = .85). The area under the receiver operating characteristic curve for the CES-DC was 0.825 when compared to MINI KID diagnoses, indicating a strong ability to distinguish between depressed and nondepressed children and adolescents in Rwanda. A cut point of≥30 corresponded with a sensitivity of 81.9% and a specificity of 71.9% in this referred sample. MINI KID diagnosis was well aligned with local expressions of depression-like problems.
Conclusion |
The CES-DC demonstrates good psychometric properties for clinical screening and evaluation in Rwanda, and should be considered for use in this and other low-resource settings. Population samples are needed to determine a generalizable cut point in nonreferred samples.
Le texte complet de cet article est disponible en PDF.Key Words : CES-DC, depression, Rwanda, validity
Plan
| This research was supported by the Peter C. Alderman Foundation, the Harvard Center for the Developing Child, and the Julie Henry Faculty Development Fund. This publication was supported by grants K01MH077246-05 and R34MH084679-02 from the National Institute of Mental Health, the Harvard Center for the Developing Child, the Julie Henry Development Fund, and the FXB Center for Health and Human Rights. |
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| Dr. Betancourt and Ms. Scorza served as the statistical experts for this research. |
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| The authors are endlessly grateful to the local research team who carried out these interviews: Charles Ingabire, Fredrick Kanyanganzi, Josee Mukandanga, Morris Munyanah, Sharon Teta, and Valentine Tuyishime of PIH/IMB. This work would not have been possible without the collaboration and dedication of PIH/IMB. For their input and review of the data, thanks also go to Margarita Alegría of Cambridge Health Alliance and Ista Zahn of the FXB Center for Health and Human Rights at the Harvard School of Public Health. Above all we thank the many Rwandan children and families that participated in this research to improve mental health assessment and interventions in their country. |
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| Disclosure: Drs. Betancourt, Kayiteshonga, Binagwaho, and Beardslee, Stulac, and Ms. Scorza, Ms. Meyers-Ohki, and Ms. Mushashi report no biomedical financial interests or potential conflicts of interest. |
Vol 51 - N° 12
P. 1284-1292 - décembre 2012 Retour au numéro
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