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A validation study of the Zanmi Lasante Depression Symptom Inventory (ZLDSI) in a school-based study population of
Rupinder K Legha1, Margaret E Gerbasi2, Mary C Smith Fawzi2
11Center for Health Services and Society, University of California, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90045 USA.
Background:
The Zanmi Lasante Depression Symptom Inventory (ZLDSI) is a screening tool for major depression used in 12 primary care clinics in Haiti's Central Plateau. Although previously validated in a clinic-based sample, the present study is the first to evaluate the validity and clinical utility of the ZLDSI for depression screening in a school-based population in central Haiti.
Methods:
We assessed depressive symptoms in a school-based sample of transitional age youth (18-22 years; n = 120) with the ZLDSI. Other mental health-related assessments included a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID) for current Major Depressive Episode, the Center for Epidemiologic Studies Depression Scale, and selected items adapted from the Global School-Based Health Survey mental health module. Diagnostic assignments of major depressive episode (MDE) were based on modified SCID interviews.
Results:
The ZLDSI demonstrated good overall accuracy in identifying current MDE (Area under the Curve = .92, 95% CI = .86, .98, p < .001). We ascertained ≥12 as the optimal cut-off point to screen for depression with a sensitivity of 100% and a specificity of 73.9%. In addition, the ZLDSI was associated with other measures of depressive symptoms, suggesting that it demonstrates construct validity.
Conclusions:
Study findings support that the ZLDSI has clinical utility for screening for depression among school-going transitional age youth.
