Depression in systemic lupus erythematosus: gender differences in the performance of the Beck Depression Inventory (BDI), Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiety and Depression Scale (HADS)

Abstract

The prevalence of depressive symptoms in patients with systemic lupus erythematosus (SLE) varies widely between different cohorts (17-75%), primarily due to factors such as the heterogeneity of the samples and the instruments used to detect depressive symptoms. Most of these instruments are self-administered questionnaires that have different characteristics and approaches to depressive symptoms. This study aimed to evaluate gender differences in the performance of three questionnaires used to assess depressive symptoms in patients with SLE: the Beck Depression Inventory (BDI), Center for Epidemiologic Studies Depression Scale (CES-D), and Hospital Anxiety and Depression Scale (HADS). This study included 54 male and 54 female SLE patients. Depressive symptoms were assessed using BDI (cutoffs 13 and 15), CES-D and HADS. The gold standard method used was the diagnostic criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Regarding the performance of the BDI questionnaire, no significant differences in sensitivity or specificity were found between the genders. The specificity of the CES-D questionnaire was significantly greater for the male group (83% vs. 62.5%, p = 0.0309), and its sensitivity was non-significantly higher for the female group (92.9% for women and 71.4% for men; p = 0.2474). Regarding the performance of the HADS, we found similar sensitivities between the genders (71.4%) but a higher specificity among the men (95.7% in men and 82.5% in women, p = 0.0741). In conclusion, our results suggest the presence of gender differences in the performance of the questionnaires in SLE patients. The BDI had the most similar performances between the male and female groups. In contrast, the CES-D and HADS-D showed considerable variation in performances between men and women with SLE.

Factor structure of the Hospital Anxiety and Depression Scale in adolescent patients with chronic disease

“…8 T h e m a j o r c o n t r i b u t i o n o f t h e HADS, compared to other anxiety and depression measurement tools (Beck Depression Inventory [BDI] or Beck Anxiety Inventory [BAI]), 13 is its focus on cognitive aspects rather than on somatic ones, which is very important for patients with CD, whose symptoms may be confused with those of anxiety and depression that accompany the disease itself. 8 The HADS has been adapted to multiple languages 11,12,[14][15][16] and administered to patients with different physical conditions. 9,11,[16][17][18][19][20][21] Although it was initially developed for people aged 16 to 65 years, 9 its use has been extended to other age ranges, from 10 to 85 years old.…”

“…8 The HADS has been adapted to multiple languages 11,12,[14][15][16] and administered to patients with different physical conditions. 9,11,[16][17][18][19][20][21] Although it was initially developed for people aged 16 to 65 years, 9 its use has been extended to other age ranges, from 10 to 85 years old. 14,17,[21][22][23][24][25][26] This is because it provides adequate information, is easily understood and can be administered in a short time.…”

La estructura factorial de la Escala hospitalaria de Ansiedad y Depresión en pacientes adolescentes con enfermedad crónica

“…8 Entre las principales aportaciones de la HADS en cuanto a otras medidas de clínica ansioso-depresiva (Beck Depression Inventory -BDI-o Beck Anxiety Inventory -BAI-), 13 está su enfoque centrado en los aspectos cognitivos frente a los somáticos, muy importante en los pacientes que presentan EC, cuyos síntomas podrían confundirse con la clínica ansioso-depresiva que acompaña la enfermedad propiamente dicha. 8 La HADS se ha adaptado a múltiples idiomas 11,12,[14][15][16] y aplicado a pacientes con distintas enfermedades físicas. 9,11,[16][17][18][19][20][21] Aunque, inicialmente, se desarrolló para personas de entre 16 y 65 años, 9 se ha ampliado el rango de edad de su uso y se ha utilizado desde los 10 años hasta los 85.…”

“…8 La HADS se ha adaptado a múltiples idiomas 11,12,[14][15][16] y aplicado a pacientes con distintas enfermedades físicas. 9,11,[16][17][18][19][20][21] Aunque, inicialmente, se desarrolló para personas de entre 16 y 65 años, 9 se ha ampliado el rango de edad de su uso y se ha utilizado desde los 10 años hasta los 85. 14,17,[21][22][23][24][25][26] Esto se debe a la información que aporta, a su fácil comprensión y a la corta duración de su aplicación.…”

“…[30][31][32] A u n q u e e s u n a e s c a l a m u y u t i l i z a d a internacionalmente en clínica e investigación, su uso se ha limitado a los adultos. 11,12,16,18 Asimismo, existen estudios realizados en adolescentes, pero en otros países. 25,31 En la actualidad, en España, no existe literatura que estudie las propiedades psicométricas de esta escala en la población adolescente.…”