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Lookup NU author(s): Professor Richard Walker,
Dr Catherine Dotchin,
Dr Stella Paddick
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© 2021 Informa UK Limited, trading as Taylor & Francis Group.Objectives: To develop a brief, culturally appropriate screening tool for identifying late life depression (LLD), for use by non-specialist clinicians in primary and out-patient care settings in sub-Saharan Africa (SSA). Background: Depressive disorders are a leading contributor to the global health burden. LLD is common and cases will increase as populations’ age, particularly in low- and middle-income countries (LMICs), such as those in SSA. A chronic mental health workforce shortage and the absence of culturally adapted LLD screening tools to aid non-specialist clinicians have contributed to a significant diagnostic gap. Design: A systematic random sample of older people attending general medical clinics were interviewed using a 30-item LLD questionnaire, developed utilizing a Delphi consensus analysis of items from the Geriatric Depression Scale, Patient Health Questionnaire-2 and questions developed from a study of lay conceptualisations of depression in Tanzania. The items were assessed for validity against blinded DSM 5 diagnosis of depression by a research doctor. Factor and item analysis were then used to refine the questionnaire. Results: The 12-item Maddison Old-age Scale for Identifying Depression (MOSHI-D) was developed. It has good internal consistency (Cronbach’s α = 0.820) and construct and criterion validity (AUROC = 0.880). Conclusions: On initial evaluation, the MOSHI-D showed good internal validity. It should be easy for non-specialists to administer. External validation and further refinement will be conducted. A culturally-appropriate LLD screen may improve mental health care integration into existing healthcare settings within SSA and facilitate greater patient access to care, in accordance with current WHO strategy.
Author(s): Howarth-Maddison M, Gamassa E, Safic S, Andrea D, Urasa S, Walker RW, Gray WK, Haule I, Dotchin CL, Paddick S-M
Publication type: Article
Publication status: Published
Journal: Aging and Mental Health
Pages: epub ahead of print
Online publication date: 04/01/2021
Acceptance date: 25/11/2020
ISSN (print): 1360-7863
ISSN (electronic): 1364-6915
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