Abstract:
Depression is one of the common comorbid mental disorders in people with epilepsy. Thus,
early detection and treatment of depression in people with epilepsy using clinically validated
instrument is vital for the improvement and overall health outcome of people suffering from
epilepsy. Hamilton depression rating scale is one of the widely used depression screening tool
validated in different languages for various population groups. However, the scale is not
validated in Ethiopia both for clinical as well as the general population.
Objective: This study aimed to assess the psychometric properties of Hamilton Depression
Rating Scale 17-item screening tool among Afaan Oromo speaking epileptic patients in Jimma
University Medical Center, Jimma, Ethiopia.
Methods: Facility based cross sectional study design was conducted in Jimma University
Medical Center among 133 study participants, using consecutive sampling method. Criterion
validity was assessed against mini international neuropsychiatric interview. The Cronbach's
alpha coefficient was used to evaluate internal consistency. Cut-off score, sensitivity,
specificity, positive and negative predictive value were determined by receiver operating
characterized analysis. Statically Package for Social Science - version -23 software was used
for analysis.
Result: A total of 133 participants (mean age 31.7 years, SD ± 10.7, 64.7% male) were included
with 100% response rate. The translated Afan Oromo version of Hamilton depression rating
scale showed no difficulty for understanding. The internal consistency showed acceptable
result with Cronbach’s alpha score of- α=0.74. The Pearson correlation coefficient result for
criterion validity revealed strong association(r=0.88). Receiver operating characteristic (ROC)
analysis revealed that sensitivity and specificity of Hamilton Depression Rating Scale 17-item
(HAMD-17) were 0.92 and 0.91 respectively together with 0.96 negative predictive value
(NPV) and 0.87 positive predictive value (PPV) at cut-off score of 9 and above. Area under the
ROC curve was 0.96.
Conclusion and recommendation: The HAMD-17 considered to be a valid and reliable
depression assessment tool, with a cutoff score ≥ 9 for people with epilepsy in Afaan Oromo
version. Hence, the use of the Afaan Oromo version of HAMD-17 as validated tool for people
with epilepsy is recommended for clinicians as well as researchers to screen for depression
