Journal of General Internal Medicine
Volume 9, Issue 4, 1994, Pages 202-206

Screening for major depression in vietnamese refugees - A validation and comparison of two instruments in a health screening population (Article)

Hinton W.L.* , Du N. , Chen Y.-C.J. , Tran C.G. , Newman T.B. , Lu F.G.
  • a Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, 02115, MA, United States
  • b the Departments of Psychiatry, University of California, San Francisco, San Francisco, California, United States
  • c the Department of Psychiatry, National Cheng-Kung University Medical College, Taiwan
  • d the Department of Psychology, Boston University, Boston, Massachusetts, United States
  • e Laboratory Medicine, University of California, San Francisco, San Francisco, California, United States
  • f the Departments of Psychiatry, University of California, San Francisco, San Francisco, California, United States

Abstract

Objectives: 1) Using standard cutoffs, to determine the accuracy of two Vietnamese-language depression screening instruments for major depression in a nonpsychiatric setting, 2) to examine the utility of other cutoffs, and 3) to compare the instruments' overall accuracies. Design: 1) A research assistant administered the Vietnamese Depression Scale (VDS) and the Indochinese Hopkins Symptom Checklist Depression Subscale (HSCL-D) to all subjects. 2) The "gold standard" was determined by a native Vietnamese-speaking psychiatrist using a written translation of a standard semistructured clinical interview. Setting: A health screening clinic at a large public hospital. Patients: A convenience sample of 206 newly arrived adult Vietnamese refugees undergoing routine, mandatory health screening. Results: The psychiatrist diagnosed 7% of the refugees as having major depression. At standard cutoffs, the VDS had a 64% sensitivity, a 98% specificity, a 75% positive predictive value, and a 97% negative predictive value. Corresponding results for the HSCL-D were 86%, 93%, 48%, and 99%. More than half of the patients who had false-positive results had other clinical disorders. For each instrument, adjusting the cutoff improved sensitivity and positive predictive value. Receiver operating characteristic (ROC) curve analysis showed no difference in accuracy between the two instruments. Each instrument took approximately 5-10 minutes to administer. Conclusions: These instruments accurately identified Vietnamese refugees with major depression and should be of use to clinicians in primary care settings. Standard cutoffs may need to be adjusted in nonpsychiatric settings. © 1994 the Society of General Internal Medicine.

Author Keywords

Screening Vietnamese refugees Depression

Index Keywords

mental deficiency Vietnam depression refugee mass screening clinical trial ROC Curve human Refugees Interview, Psychological ethnic group anxiety neurosis comparative study Depressive Disorder dysthymia United States male female Viet Nam Psychiatric Status Rating Scales Reproducibility of Results sensitivity and specificity Article Support, U.S. Gov't, P.H.S. Support, Non-U.S. Gov't adult major clinical study Predictive Value of Tests posttraumatic stress disorder
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0028205992&doi=10.1007%2fBF02600124&partnerID=40&md5=b286855bdc6c9e0ede28d4bd82564e19
DOI: 10.1007/BF02600124
ISSN: 08848734
Cited by: 54
Original Language: English