Prevalence of depression and validation of the Beck Depression Inventory‐II and the Children's Depression Inventory‐Short amongst HIV‐positive adolescents in Malawi

Journal of the International AIDS Society - Tập 17 Số 1 - 2014
Maria H. Kim1,2,3, Alick Mazenga2,3, Akash Devandra1, Saeed Ahmed1, Peter N. Kazembe2, Xiaoying Yu4, Chi Nguyen4, Carla Sharp5
1Baylor College of Medicine International Paediatric AIDS Initiative, Texas Children's Hospital, Houston, TX, USA
2Baylor College of Medicine–Abbott Fund Children's Clinical Centre of Excellence, Lilongwe, Malawi
3These authors contributed equally to the development of this manuscript.
4Department of Paediatrics, Epidemiology Center, Baylor College of Medicine, Houston, TX, USA
5Department of Psychology, University of Houston, Houston, TX, USA

Tóm tắt

IntroductionThere is a remarkable dearth of evidence on mental illness in adolescents living with HIV/AIDS, particularly in the African setting. Furthermore, there are few studies in sub‐Saharan Africa validating the psychometric properties of diagnostic and screening tools for depression amongst adolescents. The primary aim of this cross‐sectional study was to estimate the prevalence of depression amongst a sample of HIV‐positive adolescents in Malawi. The secondary aim was to develop culturally adapted Chichewa versions of the Beck Depression Inventory‐II (BDI‐II) and Children's Depression Inventory‐II‐Short (CDI‐II‐S) and conduct a psychometric evaluation of these measures by evaluating their performance against a structured depression assessment using the Children's Rating Scale, Revised (CDRS‐R).Study designCross‐sectional study.MethodsWe enrolled 562 adolescents, 12–18 years of age from two large public HIV clinics in central and southern Malawi. Participants completed two self‐reports, the BDI‐II and CDI‐II‐S, followed by administration of the CDRS‐R by trained clinicians. Sensitivity, specificity and positive and negative predictive values for various BDI‐II and CDI‐II‐S cut‐off scores were calculated with receiver operating characteristics analysis. The area under the curve (AUC) was also calculated. Internal consistency was measured by standardized Cronbach's alpha coefficient, and correlation between self‐reports and CDRS‐R by Spearman's correlation.ResultsPrevalence of depression as measured by the CDRS‐R was 18.9%. Suicidal ideation was expressed by 7.1% (40) using the BDI‐II. The AUC for the BDI‐II was 0.82 (95% CI 0.78–0.89) and for the CDI‐II‐S was 0.75 (95% CI 0.70–0.80). A score of ≥13 in BDI‐II achieved sensitivity of >80%, and a score of ≥17 had a specificity of >80%. The Cronbach's alpha was 0.80 (BDI‐II) and 0.66 (CDI‐II‐S). The correlation between the BDI‐II and CDRS‐R was 0.42 (p<0.001) and between the CDI‐II‐S and CDRS‐R was 0.37 (p<0.001).ConclusionsThis study demonstrates that the BDI‐II has sound psychometric properties in an outpatient setting among HIV‐positive adolescents in Malawi. The high prevalence of depression amongst HIV‐positive Malawian adolescents noted in this study underscores the need for the development of comprehensive services for HIV‐positive adolescents.

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Journal of the International AIDS Society

Tập 17 Số 1

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