Jennifer A Halliday1, Christel Hendrieckx2, Lucy Busija3, Jessica L Browne2, Giesje Nefs4, François Pouwer5, Jane Speight6. 1. School of Psychology, Deakin University, 1 Geringhap Street, Geelong 3220, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, 570 Elizabeth Street, Melbourne 3000, VIC, Australia. Electronic address: j.halliday@deakin.edu.au. 2. School of Psychology, Deakin University, 1 Geringhap Street, Geelong 3220, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, 570 Elizabeth Street, Melbourne 3000, VIC, Australia. 3. Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne 3000, VIC, Australia. 4. Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands; Diabeter, Center for pediatric and adolescent diabetes care and research, Blaak 6, 3011 TA Rotterdam, The Netherlands. 5. Department of Psychology, University of Southern Denmark, Campusvej 55, Odense M 5230, Denmark. 6. School of Psychology, Deakin University, 1 Geringhap Street, Geelong 3220, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, 570 Elizabeth Street, Melbourne 3000, VIC, Australia; AHP Research, Hornchurch, Essex, UK.
Abstract
AIMS: Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes. METHODS: The Diabetes MILES - Australia study dataset provided a sample of N=3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full sample, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (≤7 and <13) with the PHQ-9. RESULTS: For the whole sample, the WHO-5 demonstrated satisfactory internal consistency reliability (α=0.90) and convergent validity with the PHQ-9 (r=-0.73, p<0.001). Confirmatory factor analysis partially supported factorial validity: Χ2(5)=834.94, p<0.001; RMSEA=0.23, 90% CI 0.21-0.24; CFI=0.98, TLI=0.96; factor loadings=0.78-0.92. The AUC was 0.87 (95% CI: 0.86-0.89, p<0.001). The sensitivity/specificity of the WHO-5 for detecting likely depression was 0.44/0.96 for the ≤7 cut-off, and 0.79/0.79 for the <13 cut-off, with similar findings by diabetes type and treatment. CONCLUSIONS: These findings support use of a WHO-5 cut-point of <13 to identify likely depression in Australian adults with diabetes, regardless of type/treatment.
AIMS: Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes. METHODS: The Diabetes MILES - Australia study dataset provided a sample of N=3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full sample, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (≤7 and <13) with the PHQ-9. RESULTS: For the whole sample, the WHO-5 demonstrated satisfactory internal consistency reliability (α=0.90) and convergent validity with the PHQ-9 (r=-0.73, p<0.001). Confirmatory factor analysis partially supported factorial validity: Χ2(5)=834.94, p<0.001; RMSEA=0.23, 90% CI 0.21-0.24; CFI=0.98, TLI=0.96; factor loadings=0.78-0.92. The AUC was 0.87 (95% CI: 0.86-0.89, p<0.001). The sensitivity/specificity of the WHO-5 for detecting likely depression was 0.44/0.96 for the ≤7 cut-off, and 0.79/0.79 for the <13 cut-off, with similar findings by diabetes type and treatment. CONCLUSIONS: These findings support use of a WHO-5 cut-point of <13 to identify likely depression in Australian adults with diabetes, regardless of type/treatment.
Authors: Abdallah Badahdah; Faryal Khamis; Nawal Al Mahyijari; Marwa Al Balushi; Hashil Al Hatmi; Issa Al Salmi; Zakariya Albulushi; Jaleela Al Noomani Journal: Int J Soc Psychiatry Date: 2020-07-08
Authors: Ralph Geerling; Jessica L Browne; Elizabeth Holmes-Truscott; John Furler; Jane Speight; Kylie Mosely Journal: BMJ Open Diabetes Res Care Date: 2019-11-19
Authors: Meghan Bradway; Alain Giordanengo; Ragnar Joakimsen; Anne Helen Hansen; Astrid Grøttland; Gunnar Hartvigsen; Pietro Randine; Eirik Årsand Journal: JMIR Res Protoc Date: 2020-02-10
Authors: Ingvild Hernar; Marit Graue; David A Richards; Ragnhild B Strandberg; Roy Miodini Nilsen; Magne Rekdal; Karianne Fjeld Løvaas; Tone V Madsen; Grethe S Tell; Anne Haugstvedt Journal: BMJ Open Date: 2021-04-14 Impact factor: 2.692
Authors: Chang Liu; Melinda McCabe; Andrew Dawson; Chad Cyrzon; Shruthi Shankar; Nardin Gerges; Sebastian Kellett-Renzella; Yann Chye; Kim Cornish Journal: Int J Environ Res Public Health Date: 2021-06-22 Impact factor: 3.390
Authors: Liv Marit Valen Schougaard; Annette de Thurah; Per Bech; Niels Henrik Hjollund; David Høyrup Christiansen Journal: Health Qual Life Outcomes Date: 2018-09-06 Impact factor: 3.186