An instrument for assessment of depression among spinal cord injury patients: Comparison between the CES-D and TDI

Abstract

Objective: To search for a simple, practical and appropriate instrument for the assessment of depression among Thai SCI patients: comparison between two self-rating instruments. Material and Method: Eighty-three SCI patients were asked to complete a questionnaire composed of the Thai depression inventory (TDI) and the Center for Epidemiological Studies Depression Scale (CES-D), Thai version. All subjects were interviewed by a psychiatrist and were diagnosed according to the categories of depression of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV). Statistics: Receiver Operating Characteristic (ROC) curve and Logistic regression analysis. Results: Twenty patients were confirmed to have a depressed mood or adjustment disorder. The area under the ROC curve for the CES-D and TDI was 0.826 and 0.827. The sensitivities and specificities of the CES-D and TDI were 80.0, 69.8 per cent and 70.0, 79.4 per cent respectively. The positive predictive value and negative predictive value of the two tests were 45.7, 91.7 per cent and 51.9, 89.3 per cent. Using Logistic regression analysis, the CES-D produces a better model than the TDI (Chi-square value = 23.196 and 4.578). Conclusion: The CES-D is more appropriate for screening for depression in SCI patients than the TDI.