Improving Detection of Depression in People Living with HIV: Psychometric Properties of the South African Depression Scale (SADS)
- 18 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in AIDS and Behavior
- Vol. 25 (11), 3630-3637
- https://doi.org/10.1007/s10461-021-03305-w
Abstract
Most measures developed in high income countries to screen for major depressive disorder (MDD) among people living with HIV (PWH) demonstrate suboptimal psychometric properties when utilized in non-western, resource limited settings due to their high false positive rates. For standardized MDD screening to be implementable in local settings, a measure is needed that reduces diagnostic burden by being highly sensitive while limiting false positives. This study sought to evaluate the ability of the locally developed South African Depression Scale (SADS) to screen for MDD in PWH in Cape Town. The SADS was administered along with the SCID-5-RV as gold standard to 236 PWH. It demonstrated good discriminating ability in detecting MDD with an area under the curve of 0.85. A cut-off of 27 yielded 78.2% sensitivity and 54.4% PPV. Given its robust psychometric properties, routine use of the SADS in community clinics to screen at-risk PWH, combined with evidence-based depression treatment, could improve the health outcomes and well-being of PWH in South Africa. Resumen La mayoría de las medidas desarrolladas en países de ingresos altos para detectar el trastorno depresivo mayor (TDM) entre las personas que viven con el VIH (PVV) demuestran propiedades psicométricas subóptimas cuando se utilizan en entornos no occidentales de recursos limitados debido a sus altas tasas de falsos positivos. Para que la detección de TDM estandarizada sea implementable en entornos locales, se necesita una medida que reduzca la carga diagnóstica al ser altamente sensible mientras limita los falsos positivos. Este estudio trató de evaluar la capacidad de la Escala de Depresión Sudafricana (SADS, por sus siglas en inglés) desarrollada localmente para detectar TDM en PVV en Ciudad del Cabo. El SADS se administró junto con el SCID-5-RV como el test de referencia a 236 PWH. Demostró una buena capacidad discriminatoria en la detección de TDM con un área bajo la curva de 0,85. Un corte de 27 produjo un 78,2% de sensibilidad y un 54,4% de VPP. Dadas sus sólidas propiedades psicométricas, el uso rutinario del SADS en clínicas comunitarias para detectar las PVV en riesgo, combinado con un tratamiento de depresión basado en la evidencia, podría mejorar los resultados de salud y el bienestar de las PVV en Sudáfrica.Keywords
Funding Information
- National Institute of Mental Health (R01MH103770, R01MH103770, 1P30MH116867, F31MH122279)
- National Institute on Drug Abuse (K24DA040489)
This publication has 25 references indexed in Scilit:
- Evaluation of a collaborative care model for integrated primary care of common mental disorders comorbid with chronic conditions in South AfricaBMC Psychiatry, 2019
- Depression and Engagement in Care Among Newly Diagnosed HIV-Infected Adults in Johannesburg, South AfricaAIDS and Behavior, 2016
- Depression and Adherence to Antiretroviral Therapy in Low-, Middle- and High-Income Countries: A Systematic Review and Meta-AnalysisCurrent HIV/AIDS Reports, 2014
- Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010The Lancet, 2013
- Mental Disorder in People Living with HIV/Aids in South AfricaSouth African Journal of Psychology, 2008
- Quality of life and immune activation in patients with HIV-infectionBrain, Behavior, and Immunity, 2008
- Common Mental Disorders among HIV-Infected Individuals in South Africa: Prevalence, Predictors, and Validation of Brief Psychiatric Rating ScalesAIDS Patient Care and STDs, 2008
- Resources for mental health: scarcity, inequity, and inefficiencyThe Lancet, 2007
- Depression Is a Risk Factor for Noncompliance With Medical TreatmentArchives of Internal Medicine, 2000
- Progression to AIDSPsychosomatic Medicine, 1999