PRM157 - ‘How Does that Make You feel?’ - the Ambiguity of Translating Depression

Abstract

To identify common translation issues occurring during linguistic validation of depression scales; to assess possible solutions that could be applied across target languages. We gathered back-translation reviews from linguistic validation projects comprising four depression scales and spanning thirteen languages; identified issues faced during discussion with lead linguistic validation consultants in-country; compared problems and solutions to find any patterns; highlighted challenges common to depression scales. There were three main challenges: 1. Colloquial expressions are frequently used. Problematic items included ‘I could not get going’ and ‘I could not shake off the blues’. All languages reviewed had no colloquial equivalent for ‘shake off the blues’; we resolved to create conceptual equivalence (‘I could not get rid of my depression’/’I could not stop feeling sad’) with a conversational register to reflect the source. 2. Some symptoms of depression are challenging to translate. For example, ‘worthless’ and ‘worthwhile’ posed problems for 62% of languages. Most often, the terms were confused with ‘useless/useful’. Where there was no direct translation, and when suitable for the clinical context, these terms were translated as ‘worth nothing’ and ‘valuable’. 3. The marginally-nuanced ideas were no problem for a broad English vocabulary, however, during linguistic validation, there was difficulty differentiating between English source terms such as ‘wound-up’, ‘nervous’, ‘agitated’, ‘restless’ and ‘tense’. All target languages struggled to translate ‘nervous’ and ‘wound-up’ in two separate terms. Project managers defined the latter as ‘brought to a state of great tension’, possibly including ‘nervous movement’, and the concept was rendered successfully. Attitudes towards depression vary across different cultures. Verbatim translations are found to be risky for numerous reasons but, with careful discussion between lead linguists and project managers, conceptually-equivalent, culturally-adapted wording is found to allow for this. To the issues reviewed, similar solutions were applied across languages and in different depression scales.