Psychometric Properties Of Hamilton Depression Rating Scale Among People With Epilepsy In Jimma University Medical Center, Neurological Clinic, Southwest, Ethiopia, 2020

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