Validation and Psychometric Properties of the Spanish Version of the Hopkins Symptom Checklist-25 Scale for Depression Detection in Primary Care

Abstract

Depression constitutes a major public health problem due to its high prevalence and difficulty in diagnosis. The Hopkins Symptom Checklist-25 (HSCL-25) scale has been identified as valid, reproducible, effective, and easy to use in primary care (PC). The purpose of the study was to assess the psychometric properties of the HSCL-25 and validate its Spanish version. A multicenter cross-sectional study was carried out at six PC centers in Spain. Validity and reliability were assessed against the structured Composite International Diagnostic Interview (CIDI). Out of the 790 patients, 769 completed the HSCL-25; 738 answered all the items. Global Cronbach’s alpha was 0.92 (0.88 as calculated for the depression dimension and 0.83 for the anxiety one). Confirmatory factor analysis (CFA) showed one global factor and two correlated factors with a correlation of 0.84. Area under the curve (AUC) was 0.89 (CI 95%, 0.86–0.93%). For a 1.75 cutoff point, sensibility was 88.1% (CI 95%, 77.1–95.1%) and specificity was 76.7% (CI 95%, 73.3–79.8%). The Spanish version of the HSCL-25 has a high response percentage, validity, and reliability and is well-accepted by PC patients.

Measuring depression in Primary Health Care in Spain: Psychometric properties and diagnostic accuracy of HSCL-5 and HSCL-10

“…Employing the cutoffs corresponding to each version ( 22 ), sensitivity was similar for both genders whilst specificity was greater for men in the two short versions. Findings that concur with those reported for the HSCL-25 ( 18 ). In a study comparing the HSCL-10 with the CIDI ( 33 ), slightly higher results were reported with respect to sensitivity, although a different cutoff was employed.…”

“…For both short versions the AUC was greater in men, thus the probability of accuracy in diagnosis in males is greater. Such a gender difference has also been reported for the longer HSCL-25 ( 18 ).…”

“…In the full 25-item version, 17 “Feeling blue” was the most consistent ( 18 ). This item which asks about sadness, a basic characteristic in patients with depression, is included in the HSCL-10 and the HSCL-5 and was also the most consistent in the two short versions.…”

“…The present study was based on data from a cross-sectional multicenter study designed to validate the HSCL-25 in a Spanish PC population. This is a methodological study from a secondary data analysis and the primary data has been previously published ( 18 ). Participants were patients attending six Spanish Primary Health Centers (PHC) taking part in the EIRA study ( 34 , 35 ).…”

“…It has been shown to be valid and reliable for different populations ( 10 – 14 ), useful in PC ( 15 ), and it is available in several languages ( 16 ) including Spanish. The Spanish version of HSCL-25 was translated, culturally adapted, and validated following the COSMIN ( 17 , 18 ).…”