Development and cross-cultural testing of the International Depression Symptom Scale (IDSS): a measurement instrument designed to represent global presentations of depression

Abstract

BackgroundSelf-report measurement instruments are commonly used to screen for mental health disorders in Low and Middle-Income Countries (LMIC). The Western origins of most depression instruments may constitute a bias when used globally. Western measures based on the DSM, do not fully capture the expression of depression globally. We developed a self-report scale design to address this limitation, the International Depression Symptom Scale-General version (IDSS-G), based on empirical evidence of the signs and symptoms of depression reported across cultures. This paper describes the rationale and process of its development and the results of an initial test among a non-Western population.MethodsWe evaluated internal consistency reliability, test–retest reliability and inter-rater reliability of the IDSS-G in a sample N = 147 male and female attendees of primary health clinics in Yangon, Myanmar. For criterion validity, IDSS-G scores were compared with diagnosis by local psychiatrists using the Structured Clinical Interview for DSM (SCID). Construct validity was evaluated by investigating associations between the IDSS-G and the Patient Health Questionnaire (PHQ), impaired function, and suicidal ideation.ResultsThe IDSS-G showed high internal consistency reliability (α = 0.92), test–retest reliability (r = 0.87), and inter-rater reliability (ICC = 0.90). Strong correlations between the IDSS-G and PHQ-9, functioning, and suicidal ideation supported construct validity. Criterion validity was supported for use of the IDSS-G to identify people with a SCID diagnosed depressive disorder (major depression/dysthymia). The IDSS-G also demonstrated incremental validity by predicting functional impairment beyond that predicted by the PHQ-9. Results suggest that the IDSS-G accurately assesses depression in this population. Future testing in other populations will follow.

Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria

“…For example, several items were interpreted in FGDs as non-specific to mental illness, such as tummy aches, not enjoying food, or trouble sleeping. Previous studies have likewise found that such items require specific adaptations to differentiate them from experiences of diarrheal disease, hunger, or other stressors (Kohrt et al ., 2007, 2011, 2016; Hanlon et al ., 2008; Kaiser et al ., 2013; Haroz et al ., 2017; Mazzuca et al ., 2019). While some of these items appeared to function well following adaptation (e.g., not enjoying food), other items (e.g., tummy aches) were endorsed in a different pattern than other items, suggesting that they might continue to be endorsed outside the experience of emotional distress.…”

Adaptation and testing of an assessment for mental health and alcohol use problems among conflict-affected adults in Ukraine

“…These kinds of measures are frequently lacking for conflict-affected populations, owing to difficulty and cost of local adaptation and testing. The methods and procedures used in this study (and based on research described elsewhere [ 10 , 11 , 13 ]) were designed for relatively rapid investigations among conflict-affected populations.…”

“…Lacking locally validated measures, we tried to match the findings of the qualitative study to instruments our team had previously developed for cross-cultural use: the International Depression Symptoms Scale (IDSS) [ 13 ] and the Global Post Traumatic Stress Symptom Scale (GPTSS) [ 14 ]. The IDSS and GPTSS are self-report measures made up of a core set of symptoms—for depression and post-traumatic stress, respectively—that have been found through literature review to occur across diverse populations.…”

Testing the effectiveness and implementation of a brief version of the Common Elements Treatment Approach (CETA) in Ukraine: a study protocol for a randomized controlled trial

“…The baseline assessment consists of demographic information and scales to measure our primary outcomes: symptoms of depression, PTS, and impaired functioning; and secondary outcomes: alcohol use and anxiety symptoms. Briefly, based on our initial qualitative work, we identified, adapted, and tested appropriate mental health scales, including the International Depression Symptom Scale (IDSS) [ 34 ], the Global Post-traumatic Stress Symptom Scale (GPTSS) [ 35 ], the Anxiety sub-scale of the Hopkins Symptom Checklist (HSCL-A), and the Alcohol Smoking and Substance Involvement Screening Test (ASSIST 3.0) [ 36 , 37 ]. The IDSS and GPTSS were developed based on presentation of depression and PTS globally.…”