Performance of depression rating scales in patients with chronic kidney disease: an item response theory-based analysis

Abstract

Objective Because there is overlap between somatic symptoms of depression and symptoms of chronic kidney disease (CKD), it is unclear if self-reported depression rating scales can be used accurately in predialysis CKD patients, especially if CKD and other comorbidities are symptomatic. We assessed the performance of two depression scales — the Beck Depression Inventory (BDI) and the Quick Inventory of Depression Symptomatology (QIDS-SR16) — by CKD stage, diagnosis of diabetes and total medical comorbidity burden —using item response theory (IRT) in a sample of 272 predialysis CKD patients. Methods We performed IRT by low versus high CKD stage, diabetes versus no diabetes and high (>3 diagnoses) versus low medical comorbidity burden. Results IRT models of each rating scale were affected in a limited way by CKD stage, diabetes and medical comorbidity burden. Sleep disturbances on the QIDS-SR16 were more discriminatory for depression in diabetics and those with high comorbidity burden. Pessimism and guilt from the BDI compared to QIDS-SR16 were more discriminatory of depression in the high CKD and high comorbidity groups, respectively. Conclusions Overall item differences were modest, and chronic disease severity by CKD stage, diabetes mellitus or other medical comorbidities did not appreciably contribute to differences in scale performance.

Depression and Associated Factors in Chinese Patients With Chronic Kidney Disease Without Dialysis: A Cross-Sectional Study

“…However, some studies have reported that patients with stage 4 or 5 CKD are more likely to have depression than those in early stages of the disease (51,53). These inconsistent findings may be attributable to the BPI scale used in our study, which can effectively screen out depression without impacting disease severity (advanced CKD stage or comorbidities) (36). Additional studies with a larger sample of patients at different stages of CKD are needed to clarify the development of depression in CKD.…”

“…Depression was evaluated with the Beck Depression Inventory-II (BDI-II), a 21-item questionnaire with total score ranging from 0-63 (35) and each item scored from 0-3 on a Likert scale. The BDI-II has satisfactory internal consistency and reliability for assessing CKD patients without dialysis (36). In this study, depression was defined as a BDI-II score ≥11 (37).…”

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)

“…A tendency toward overestimation in the diagnosis of depression with the use of some self-administered questionnaires has been described in other studies evaluating patients with various chronic diseases. 65,66 This effect may not be uniform among the questionnaires and may become greater as the depressive symptoms covered by the questionnaire overlap with the symptoms caused by the patient’s disease. 65 In our study, we observed a lower tendency toward overestimation of the prevalence of depression when the HADS-D was used because the items related to the physical manifestations of depression (weight loss, loss of appetite, sleep disturbances, and fatigue), which were present in both the BDI and CES-D, were not contemplated therein.…”

Predicting the longitudinal changes of levodopa dose requirements in Parkinson’s disease using item response theory assessment of real‐world Unified Parkinson's Disease Rating Scale

“…Pharmaceutical and medical researchers are increasingly adopting IRT to analyze composite scores used for medical diagnosis, such as the Alzheimer's Disease Assessment Scale-Cognitive subscale 3 and others. [4][5][6][7] It has been successfully applied to modeling UPDRS progression in patients with PD as well. [8][9][10] When used in these contexts, latent ability or trait is often interpreted as latent disease severity.…”