Psychometric evaluation of the Fatigue Severity Scale in patients with major depression

Abstract

Objectives: To investigate (1) the diagnostic value of the Signs of Depression Scale (SODS) in a Likert scale format and (2) whether the Likert scale improves the diagnostic value compared with the original dichotomous scale. Design: Cross-sectional multicentre study. Setting: One general and one university hospital in the Netherlands. Subjects: A total of 116 consecutive hospitalized stroke patients, of whom 53 were patients with communicative impairment. Main measures: Depression was diagnosed with the Composite International Diagnostic Interview (CIDI) administered to the patients' relatives. The Barthel Index (BI) was used as an external validator. Results: The correlation between the CIDI and the SODS-Likert or the SODS was small (r b = 0.18), and the correlation between the Barthel Index and the SODS-Likert (r s = −0.30) or the SODS (r s = −0.33) was moderate. For both instruments, the discriminatory power for diagnosing depression when compared with the CIDI was best at a cutoff score of ⩾2. The internal consistency of the SODS-Likert was acceptable (α = 0.69) and slightly higher than that of the SODS (α = 0.57). The inter-rater reliability of the SODS-Likert and the SODS was acceptable (intraclass correlation coefficient (ICC) 0.66 and ICC 0.80, respectively). The clinical utility was rated good. Conclusion: The diagnostic value of the SODS did not improve using a Likert scale format. However, the diagnostic value of the original dichotomous SODS is reasonable for the initial mood assessment of stroke patients with communicative impairment.

Validity and reliability of the FSS in Greek MS patients

“…For the purposes of the study, we used the validated Greek BDI-II version (Tzemos 1984). The use of the BDI-II is for the concurrent validity and in accordance to literature some researchers used it (Armutlu et al 2008; Katsarou et al 2007) and others used another depression scale (Ferentinos et al 2010; Azimian et al 2009). …”

“…The FSS has been translated to numerous languages and its psychometric properties have been assessed in different populations such as patients with chronic hepatitis C (Kleinman et al 2000), spinal cord injury (Anton et al 2008), depression (Ferentinos et al 2010), systematic lupus erythematosus (Mattsson et al 2008) and the general population (Lerdal et al 2005). The validity and reliability of the FSS for MS patients has been examined in many countries such as Holland (Rietberg et al 2010), Turkey (Armutlu et al 2008), Switzerland (Valko et al 2008), U.K (Mills et al 2009), and Iran (Azimian et al 2009), while it has not been examined in Greece so far.…”

“…The validity and reliability of the FSS for MS patients has been examined in many countries such as Holland (Rietberg et al 2010), Turkey (Armutlu et al 2008), Switzerland (Valko et al 2008), U.K (Mills et al 2009), and Iran (Azimian et al 2009), while it has not been examined in Greece so far. The only two Greek studies found examined patients with major depression (Ferentinos et al 2010), and Parkinson (Katsarou et al 2007). Ferentinos et al (Ferentinos et al 2010), reported results from exploratory factor analysis, concurrent and discriminant validity, while Katsarou et al (Katsarou et al 2007) stated that the FSS had sufficient concurrent validity and internal consistency.…”

“…The only two Greek studies found examined patients with major depression (Ferentinos et al 2010), and Parkinson (Katsarou et al 2007). Ferentinos et al (Ferentinos et al 2010), reported results from exploratory factor analysis, concurrent and discriminant validity, while Katsarou et al (Katsarou et al 2007) stated that the FSS had sufficient concurrent validity and internal consistency. There is lack however, of validation in Greek population with MS and no confirmatory factor analytic results have been reported in the literature so far.…”

Discriminating Between Fatigue and Sleepiness in the Naval Operational Environment

“…However, this cutoff point has not received wide acceptance. Whereas some researchers use an FSS score ≥ 4 to identify elevated fatigue levels (Armutlu et al, 2007;Krupp et al, 1989;Valko, Bassetti, Bloch, Held, & Baumann, 2008), others have used an FSS score ≥ 5.4 to indicate clinically significant fatigue in patients with major depression (Ferentinos, Kontaxakis, Havaki-Kontaxaki, Dikeos, & Lykouras, 2011). Still others have used an FSS score of > 3 to indicate fatigue (Hossain et al, 2005;Merkelbach & Schulz, 2006).…”