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Culturally sensitive validation of screening questionnaires for depression in older African– Caribbean people living in south London

Published online by Cambridge University Press:  03 January 2018

Melanie A. Abas ,
Courtney Phillips ,
Janet Carter ,
Joanna Walter ,
Sube Banerjee  and
Raymond Levy
Melanie A. Abas
Affiliation:
Institute of Psychiatry, London
Courtney Phillips
Affiliation:
Camden and Islington Mental Health Resource Unit, London
Janet Carter
Affiliation:
Institute of Psychiatry, London
Joanna Walter
Affiliation:
St Georges Hospital Medical School, London
Sube Banerjee
Affiliation:
Institute of Psychiatry, London
Raymond Levy
Affiliation:
Institute of Psychiatry, London
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Abstract

Background

We tested the validity of two screens for depression in older African–Caribbean adults, the 15-item Geriatric Depression Scale (GDS) and a new Caribbean Culture-Specific Screen for emotional distress (CCSS). Two independent criteria were used for validity: (a) a psychiatric diagnosis derived from GMS–AGECAT, and (b) a culturally sensitive assessment of mental disorder, derived from a tool developed with local African–Caribbean religious healers.

Method

One hundred and sixty-four consecutive African–Caribbean primary care users, aged 60 years or older, were screened with the GDS and the CCSS. Diagnostic interviews were carried out on 80% of high scorers and 20% of low scorers.

Results

The number of cases detected by the two separate diagnostic approaches was similar. However, the agreement between who was and who was not a case was only modest. At a cutoff of $5, the GDS was an adequate case detector for psychiatric depression, and, at a cut-off of $4, for ‘depressed/lost spirit’, as defined by culture-specific criteria. It performed as well as the new CCSS.

Conclusions

At a cut-off of $4 the 15-item GDS can be recommended as a case detector for significant forms of depression in older African–Caribbean people living in south London.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 3 , September 1998 , pp. 249 - 254
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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