Psychometric properties of the Slovenian version of the cardiac depression scale

Palandačič, Anja Kokalj; Ucman, Saša; Lainščak, Mitja; Šarotar, Brigita Novak

doi:10.2478/sjph-2023-0003

Abstract

Introduction

The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease.

Methods

A total of 272 patients with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed.

Results

Cronbach’s alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations.

Conclusions

The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.

References

Vodička S, Naji HF, Zelko E. The role of telecardiology in dealing with patients with cardiac rhythm disorders in family medicine – systematic review. Zdr Varst. 2020;59:108-16. doi: 10.2478/sjph-2020-0014.
Open DOI Search in Google Scholar Back to article
Thombs BD, de Jonge P, Coyne JC, Whooley MA, Frasure-Smith N, Mitchell AJ, et al. Depression screening and patient outcomes in cardiovascular care: a systematic review. JAMA. 2008;300:2161-71. doi: 10.1001/jama.2008.667.
Open DOI Search in Google Scholar Back to article
Meijer A, Conradi HJ, Bos EH, Anselmino M, Carney RM, Denollet J, et al. Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: individual patient data meta-analysis. Br J Psychiatry. 2013;203:90-102. doi: 10.1192/bjp. bp.112.111195.
Open DOI Search in Google Scholar Back to article
Lichtman JH, Froelicher ES, Blumenthal JA, Carney RM, Doering LV, Frasure-Smith N, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations. Circulation. 2014;129:1350-69. doi:10.1161/ CIR.0000000000000019.
Open DOI Search in Google Scholar Back to article
Ruo B, Rumsfeld JS, Hlatky MA, Liu H, Browner WS, Whooley MA. Depressive symptoms and health-related quality of life: the Heart and Soul Study. JAMA. 2003;290:215-21. doi: 10.1001/jama.290.2.215.
Open DOI Search in Google Scholar Back to article
Vaccarino V, Badimon L, Bremner JD, Cenko E, Cubedo J, Dorobantu M, et al. Depression and coronary heart disease: 2018 position paper of the ESC working group on coronary pathophysiology and microcirculation. Eur Heart J. 2019;41:1687-96. doi: 10.1093/eurheartj/ehy913.
Open DOI Search in Google Scholar Back to article
Palandacic AK, Sarotar BN. Anksioznost in koronarna bolezen srca. Zdrav Vestn. 2017;86:523-31. doi: 10.6016/ZdravVestn.2430.
Open DOI Search in Google Scholar Back to article
Rifel J. Preventivni pregled na področju depresije. In: Govc Erzen J, Petek Šter M. editors. Priročnik za zdravnike družinske medicine. Ljubljana: National Institute of Public Health, 2017:80-3. Accessed April 10th, 2022 at: https://www.dlib.si/stream/URN:NBN:SI:doc-YTUWBHP3/4878dfe8-5673-4521-830f-31c089906834/PDF.
Search in Google Scholar Back to article
Hare DL, Davis CR. Cardiac Depression Scale: validation of a new depression scale for cardiac patients. J Psychosom Res. 1996;40:37986. doi: 10.1016/0022-3999(95)00612-5.
Open DOI Search in Google Scholar Back to article
American Psychiatric Association. Depressive disorders. In: American Psychiatric Association, editor. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association, 2013:155-89.
Search in Google Scholar Back to article
Plesnicar-Kores B, Plesnicar A. Depresija in koronarna bolezen srca. Zdrav Vestn. 2007;76:329-33.
Search in Google Scholar Back to article
McManus D, Pipkin SS, Whooley MA. Screening for depression in patients with coronary heart disease (data from the Heart and Soul Study). Am J Cardiol. 2005;96:1076-81. doi: 10.1016/j.amjcard.2005.06.037.
Open DOI Search in Google Scholar Back to article
Gholizadeh L, Salamonson Y, Davidson PM, Parvan K, Frost SA, Chang S, et al. Cross-cultural validation of the Cardiac Depression Scale in Iran. Br J Clin Psychol. 2010;49:517-28. doi: 10.1348/014466509X478709.
Open DOI Search in Google Scholar Back to article
Celano CM, Huffman JC. Depression and cardiac disease: a review. Cardiol Rev. 2011;19:130-42. doi: 10.1097/CRD.0b013e31820e8106.
Open DOI Search in Google Scholar Back to article
Palandacic AK, Radez J, Ucman S, Lainscak M, Sarotar BN. Evaluating anxiety in elective coronary angiography study: rationale, design, and study methodology. J Cardiovasc Med (Hagerstown). 2022;23:678-84. doi: 10.2459. 0000000000001355.
Open DOI Search in Google Scholar Back to article
Shi WY, Stewart AG, Hare DL. Major depression in cardiac patients is accurately assessed using the cardiac depression scale. Psychother Psychosom. 2010;79:391-2. doi: 10.1159/000320897.
Open DOI Search in Google Scholar Back to article
Birks Y, Roebuck A, Thompson DR. A validation study of the Cardiac Depression Scale (CDS) in a UK population. Br J Health Psychol. 2004;9:15-24. doi: 10.1348/135910704322778696.
Open DOI Search in Google Scholar Back to article
Chavez CA, Ski CF, Thompson DR. Psychometric properties of the Cardiac Depression Scale: a systematic review. Heart Lung Circ. 2014;23:610-8. doi: 10.1016/j.hlc.2014.02.020.
Open DOI Search in Google Scholar Back to article
Wang W, Thompson DR, Chair SY, Hare DL. A psychometric evaluation of a Chinese version of the Cardiac Depression Scale. J Psychosom Res. 2008;65:123-9. doi: 10.1016/j.jpsychores.2008.03.010.
Open DOI Search in Google Scholar Back to article
Papasavvas T, Al-Amin H, Ghabrash HF, Micklewright D. Translation and validation of the Cardiac Depression Scale to Arabic. Asian J Psychiatr. 2016;22:60-6. doi: 10.1016/j.ajp.2016.05.001.
Open DOI Search in Google Scholar Back to article
Al-Zaru IM, Hayajneh AA, Al-Dwaikat T. Psychometric properties of the Arabic version of the cardiac depression scale tested on Jordanian patients with cardiovascular diseases. BMC Psychiatry. 2020;20:246. doi: 10.1186/s12888-020-02651-8.
Open DOI Search in Google Scholar Back to article
Hare DL, Meyer K, McBurney H. Cross-cultural robustness of depressed mood in cardiac patients — the German language version of the cardiac depression scale. Heart Lung Circ. 2000;9:PA167. doi: 10.1046/j.1443-9506.2000.09107.x.
Open DOI Search in Google Scholar Back to article
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385-401. doi: 10.1177/014662167700100306.
Open DOI Search in Google Scholar Back to article
Shaffer K. Center for Epidemiologic Studies Depression (CES-D) Scale. In: Michalos AC, editor. Encyclopedia of quality of life and well-being research. Dordrecht: Springer Science Business Media, 2014:637-41.
Search in Google Scholar Back to article
Chokkanathan S, Mohanty J. Factor structure of the CES-D scale among older adults in Chennai, India. Aging Ment Health. 2013;17:517-25. doi: 10.1080/13607863.2012.751580.
Open DOI Search in Google Scholar Back to article
Zhang Y, Ting RZW, Lam MHB, Lam SP, Yeung RO, Nan H, et al. Measuring depression with CES-D in Chinese patients with type 2 diabetes: the validity and its comparison to PHQ-9. BMC Psychiatry. 2015;15:198. doi: 10.1186/s12888-015-0580-0.
Open DOI Search in Google Scholar Back to article
Fava GA. Assessing depressive symptoms across cultures: Italian validation of the CES-D self-rating scale. J Clin Psychol. 1983;39:249-51. doi: 10.1002/1097-4679(198303)39:2<;249::aid-jclp2270390218>3.0.co;2-y.
Open DOI Search in Google Scholar Back to article
Morin AJS, Moullec G, Maiano C, Layet L, Just JL, Ninot G. Psychometric properties of the Center for Epidemiologic Studies Depression Scale (CES-D) in French clinical and nonclinical adults. Rev Epidemiol Sante Publique. 2011;59:327-40. doi: 10.1016/j.respe.2011.03.061.
Open DOI Search in Google Scholar Back to article
Wu Q, Erbas Y, Brose A, Kuppens P, Janssen R. The factor structure, predictors, and percentile norms of the Center for Epidemiologic Studies Depression (CES-D) Scale in the Dutch-speaking adult population of Belgium. Psychol Belg. 2016;56:1-12. doi: 10.5334/ pb.261.
Open DOI Search in Google Scholar Back to article
Avsec A, Musek J. Self-discrepancies in agentic and communal personality traits as predictors of well.being. Studia Psychol. 2010;52:117-31.
Search in Google Scholar Back to article
Kranjec E, Košir K, Komidar L. Dejavniki akademskega odlašanja : vloga perfekcionizma, anksioznosti in depresivnosti. Psihol Obz. 2016;25:51–62. doi: 10.20419/2016.25.445.
Open DOI Search in Google Scholar Back to article
Lajlar N, Moharić M, Vidmar G. Psihometrične lastnosti slovenskega prevoda vprašalnika o kakovosti življenja pri bolnikih z genetsko obliko živčno-mišičnih bolezni. Rehabil. 2021;2:4-12. Accessed October 1st, 2022 at: https://ibmi.mf.uni-lj.si/rehabilitacija/vsebina/Rehabilitacija_2021_No2_p04-12.pdf.
Search in Google Scholar Back to article
Kos T. Preverjanje zanesljivosti in veljavnosti slovenskega prevoda OQ-45,2. Accessed September 26th, 2022 at: http://www.skzp.si/wp-content/uploads/2016/02/Kairos_2009_let3_34.pdf.
Search in Google Scholar Back to article
Podvornik N, Globevnik Velikonja V, Praper P. Depression and anxiety in women during pregnancy in Slovenia. Zdr Varst. 2015;54:45-50. doi: 10.1515/sjph-2015-0006.
Open DOI Search in Google Scholar Back to article
Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):467-72. doi: 10.1002/acr.20561.
Open DOI Search in Google Scholar Back to article
Spielberger C. Manual for the State-Trait Anxiety Inventory. Rev. ed. Palo Alto (CA): Consulting Psychologists Press, 1983.
Search in Google Scholar Back to article
McDowell I. The State-Trait Anxiety Inventory. In: McDowell I, editor. Measuring health: a guide to rating scales and questionnaires. New York: Oxford University Press, 2006:319-26.
Search in Google Scholar Back to article
Ravnjak T. Značilnosti spoprijemanja in čustveni problemi v povezavi s kvaliteto življenja na slovenskem vzorcu onkoloških bolnikov. Psihol Obz. 2011;20:25–36.
Search in Google Scholar Back to article
Mahnič J, Tušak M. Osebnostna struktura in motivacijske značilnosti športnikov v rizičnih športih. Psihol Obz. 2005;14:107–21.
Search in Google Scholar Back to article
Schermelleh-Engel K, Moosbrugger H, Müller H. Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res Online. 2003;8:23–74. Accessed April 2nd, 2022 at: https://www.stats.ox.ac.uk/~snijders/mpr_Schermelleh.pdf.
Search in Google Scholar Back to article
Kline RB. Principles and practice of structural equation modeling. 4th ed. New York: The Guilford Press, 2015.
Search in Google Scholar Back to article
Rosseel Y. lavaan: an R package for structural equation modeling. J Stat Soft. 2012;48:1-36. doi: 10.18637/jss.v048.i02.
Open DOI Search in Google Scholar Back to article
Epskamp S. semPlot: path diagrams and visual analysis of various SEM packages output. 2019. Accessed April 2nd, 2022 at: https://cran.r-project.org/web/packages/semPlot/semPlot.pdf.
Search in Google Scholar Back to article
Wise FM, Harris DW, Carter LM. Validation of the Cardiac Depression Scale in a cardiac rehabilitation population. J Psychosom Res. 2006;60:177-83. doi: 10.1016/j.jpsychores.2005.07.019.
Open DOI Search in Google Scholar Back to article
Kiropoulos LA, Meredith I, Tonkin A, Clarke D, Antonis P, Plunkett J. Psychometric properties of the cardiac depression scale in patients with coronary heart disease. BMC Psychiatry. 2012;12:216. doi: 10.1186/1471-244x-12-216.
Open DOI Search in Google Scholar Back to article
McGraw K, Wong S. Forming inferences about some intraclass correlation coefficients. Psychol Methods. 1996;1(1):30-46.
Search in Google Scholar Back to article
Di Benedetto M, Lindner H, Hare DL, Kent S. Depression following acute coronary syndromes: a comparison between the Cardiac Depression Scale and the Beck Depression Inventory II. J Psychosom Res. 2006;60:13-20. doi: 10.1016/j.jpsychores.2005.06.003.
Open DOI Search in Google Scholar Back to article
Nia HS, Sharif SP, Froelicher ES, Boyle C, Goudarzian AH, Yaghoobzadeh A, et al. Psychometric evaluation of a Persian version of the Cardiac Depression Scale in Iranian patients with acute myocardial infarction. J Nurs Meas. 2018;26(1):1-15. doi: 10.1891/1061-3749.26.1.E1.
Open DOI Search in Google Scholar Back to article
Frasure-Smith N, Lespérance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry. 2008;65:62-71. doi: 10.1001/ archgenpsychiatry.2007.4.
Open DOI Search in Google Scholar Back to article
Doering LV, Moser DK, Riegel B, McKinley S, Davidson P, Baker H, et al. Persistent comorbid symptoms of depression and anxiety predict mortality in heart disease. Int J Cardiol. 2010;145:188-92. doi: 10.1016/j.ijcard.2009.05.025.
Open DOI Search in Google Scholar Back to article
Streiner DL, Norman GR, Cairney J. From items to scales In: Streiner DL, Norman GR, Cairney J, editors. Health Measurement Scales: a practical guide to their development and use. 5th ed. Oxford: Oxford University Press; 2015:131-58.
Search in Google Scholar Back to article
Vilagut G, Forero CG, Barbaglia G, Alonso J. Screening for depression in the general population with the Center for epidemiologic studies depression (CES-D): a systematic review with meta-analysis. PLoS One. 2016;11:e0155431. doi: 10.1371/journal.pone.0155431.
Open DOI Search in Google Scholar Back to article
Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J. 2014;35(21):136572. doi: 10.1093/eurheartj/eht462.
Open DOI Search in Google Scholar Back to article
Vu K, Claggett BL, John JE, Skali H, Solomon SD, Mosley TH, et al. Depressive symptoms, cardiac structure and function, and risk of incident heart failure with preserved ejection fraction and heart failure with reduced ejection fraction in late life. J Am Heart Assoc. 2021;10(23):e020094. doi: 10.1161/JAHA.120.020094.
Open DOI Search in Google Scholar Back to article
González-Roz A, Gaalema DE, Pericot-Valverde I, Elliott RJ, Ades PA. A systematic review of the diagnostic accuracy of depression questionnaires for cardiac populations: implications for cardiac rehabilitation. J Cardiopulm Rehabil Prev. 2019;39(6):354-64. doi: 10.1097/HCR.0000000000000408.
Open DOI Search in Google Scholar Back to article
Gersak BM, Kukec A, Steen H, Montenbruck M, Šoštarič M, Schwarz AK, et al. Relationship between quality of life indicators and cardiac status indicators in chemotherapy patients. Zdr Varst. 2021;60(4):199209. doi: 10.2478/sjph-2021-0028.
Open DOI Search in Google Scholar Back to article