An Instrument for Assessment of Depression among Spinal Cord Injury Patients : Comparison between the CES-D and TDI
VILAI KUPTNIRAT SAIKUL, M.D.* , SUDSABUY CHULAKADABBA, M.D.**, SOMSRI RA TANAV UITRASIL, M.D. ***
Affiliation : * Department of Rehabilitation Medicine, ** Department of Psychiatry, *** Clinical Epidemiology Unit, Office of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Objective : To search for a simple, practical and appropriate instrument for the assessment of depression among Thai SCI
Patients : comparison between two self-rating instruments.
Materials and Methods : Eighty-three SCI patients were asked to complete a questionnaire composed of the Thai depression inventory (TDI) and the Center for Epidemiological Studies Depres sion Scale (CES-D), Thai version. All subjects were interviewed by a psychiatrist and were diag nosed according to the categories of depression of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV).
Statistics : Receiver Operating Characteristic (ROC) curve and Logistic regression analysis.
Results :Twenty patients were confirmed to have a depressed mood or adjustment disorder. The area under the ROC curve for the CES-D and TDI was 0.826 and 0.827. The sensitivities and specificities of the CES-D and TDI were 80.0, 69.8 per cent and 70.0, 79.4 per cent respectively. The positive predictive value and negative predictive value of the two tests were 45.7, 91.7 per cent and 51.9, 89.3 per cent. Using Logistic regression analysis, the CES-D produces a better model than the TDI (Chi-square value = 23.196 and 4.578).
Conclusion : The CES-D is more appropriate for screening for depression in SCI patients than the TDI.
Keywords : Depression, Assessment, SCI, CES-D, TDI
