Abstract
BackgroundDepression is a common co-morbid health problem in patients with diabetes that is underrecognised. Current international guidelines recommend screening for depression in patients with diabetes. Yet, few depression screening instruments have been validated for use in this particular group of patients. Aim of the present study was to investigate the psychometric properties of the Turkish version of the Centre for Epidemiologic Studies Depression Scale (CES-D) in patients with type 2 diabetes.MethodsA sample of 151 Turkish outpatients with type 2 diabetes completed the CES-D, the World Health Organization-Five Well-Being Index (WHO-5), and the Problem Areas in Diabetes scale (PAID). Explanatory factor analyses, various correlations and Cronbach's alpha were investigated to test the validity and reliability of the CES-D in Turkish diabetes outpatients.ResultsThe original four-factor structure proposed by Radloff was not confirmed. Explanatory factor analyses revealed a two-factor structure representing two subscales: (1) depressed mood combined with somatic symptoms of depression and (2) positive affect. However, one item showed insufficient factor loadings. Cronbach's alpha of the total score was high (0.88), as were split-half coefficients (0.77-0.90). The correlation of the CES-D with the WHO-5 was the strongest (r = -0.70), and supported concurrent validity.ConclusionThe CES-D appears to be a valid measure for the assessment of depression in Turkish diabetes patients. Future studies should investigate its sensitivity and specificity as well as test-retest reliability.
Highlights
Depression is a common co-morbid health problem in patients with diabetes that is underrecognised
On average the sample consisted of elderly patients as it is usual in type 2 diabetes, but it can be seen that several young participants (6% of the whole sample < 40 years) were already diagnosed with type 2 diabetes
The fact that we found a 2-factor structure with positively and negatively worded items is in line with results from several other self-report measures since it is common that positively and negatively worded items load on different factors
Summary
Depression is a common co-morbid health problem in patients with diabetes that is underrecognised. Aim of the present study was to investigate the psychometric properties of the Turkish version of the Centre for Epidemiologic Studies Depression Scale (CES-D) in patients with type 2 diabetes. The prevalence of diabetes in Turkey was estimated at 2.9 million [14] This would mean that approximately 290.000 to 580.000 Turkish people suffer from both diabetes and co-morbid depression. We aimed to explore the latent structure of the CES-D (Turkish version) as earlier research has described different factor structures for this scale As a result, it is unclear which factor structure should be used in Turkish participants (and in diabetic Turkish patients)
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