Diagnosing depression in primary care: a Rasch analysis of the Major Depression Inventory.

Objective: This study aimed to assess the measurement properties of the Major Depression Inventory (MDI) in a clinical sample of primary care patients. Design: General practitioners (GPs) handed out the MDI to patients aged 18–65 years on clinical suspicion of depression. Setting: Thirty-seven gener...

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Publicado en:Scandinavian Journal of Primary Health Care Vol. 37; no. 2; pp. 256 - 264
Autores principales: Christensen, Kaj Sparle, Oernboel, Eva, Nielsen, Marie Germund, Bech, Per
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Jun2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2019
      vid: 37
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      pub: Taylor & Francis Ltd
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        10.1080/02813432.2019.1608039
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        atl: Diagnosing depression in primary care: a Rasch analysis of the Major Depression Inventory.
      aug:
        au:
          Christensen, Kaj Sparle
          Oernboel, Eva
          Nielsen, Marie Germund
          Bech, Per
        affil: Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
      sug:
        subj:
          Depression Diagnosis
          Instrument Validation
          Primary Health Care
          Human
          Rasch Analysis
          Physicians, Family
          Adolescence
          Adult
          Middle Age
          Aged
          Denmark
          Male
          Female
          Data Analysis Software
          Questionnaires
          Health Screening
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objective: This study aimed to assess the measurement properties of the Major Depression Inventory (MDI) in a clinical sample of primary care patients. Design: General practitioners (GPs) handed out the MDI to patients aged 18–65 years on clinical suspicion of depression. Setting: Thirty-seven general practices in the Central Denmark Region participated in the study. Patients: Data for 363 patients (65% females, mean age: 49.8 years, SD: 17.7) consulting their GP were included in the analysis. Main outcome measures: The overall fit to the Rasch model, individual item and person fit, and adequacy of response categories were tested. Statistical tests for local dependency, unidimensionality, differential item functioning, and correct targeting of the scale were performed. The person separation reliability index was calculated. All analyses were performed using RUMM2030 software. Results: Items 9 and 10 demonstrated misfit to the Rasch model, and all items demonstrated disordered response categories. After modifying the original six-point to a five-point scoring system, ordered response categories were achieved for all 10 items. The MDI items seemed well targeted to the population approached. Model fit was also achieved for core symptoms of depression (items 1–3) and after dichotomization of items according to diagnostic procedure. Conclusion: Despite some minor problems with its measurement structure, the MDI seems to be a valid instrument for identification of depression among adults in primary care. The results support screening for depression based on core symptoms and dichotomization of items according to diagnostic procedure. The Major Depression Inventory (MDI) is widely used for screening, diagnosis and monitoring of depression in general practice. This study demonstrates misfit of items 9 and 10 to the Rasch model and a need to modify the scoring system The findings support screening for depression based on core symptoms and dichotomization of items according to diagnostic procedure. Minor problems with measurement structure should be addressed in future revisions of the MDI.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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