Exploring the differences in psychometric properties of commonly used self-rating depression scales across various...

Depression, a mental health condition affecting millions globally, poses significant challenges in clinical diagnosis and treatment due to its unclear pathophysiological mechanism and lack of effective diagnostic biomarkers. While rating scales remain crucial for identifying and evaluating depression, their reliability and validity across diverse populations remain understudied. This study aims to systematically compare the internal consistency reliability and criterion validity of four commonly used self-rating depression scales, the Patient Health Questionnaire-9 (PHQ-9), the Zung Self-Rating Depression Scale (SDS), the Beck Depression Inventory (BDI), and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) in Chinese populations.

A quantitative systematic review was conducted, encompassing a literature search of Chinese and English medical databases, screening and selection of eligible studies, and data extraction. Internal consistency reliability (Cronbach's α) and criterion validity (correlation coefficients) of each scale were compared across studies and sub-populations. Data analyses were performed using R language version 4.3.1.

A total of 53 studies involving 35,676 participants were included. PHQ-9 was validated in more diverse sub-populations than the other scales. The BDI exhibited the highest overall internal consistency reliability. PHQ-9 and QIDS-SR demonstrated lower internal consistency reliabilities among older adults. BDI had relatively lower Cronbach's α in female patients with infertility, while SDS had relatively lower Cronbach's α among patients with liver cirrhosis and women in rural areas. Criterion validities varied across scales, with the most frequently used criterion being the Hamilton Depression Scale-17 (HAMD-17).

This systematic review provides valuable insights into the psychometric properties of commonly used depression scales in Chinese populations. The findings highlight the need for further research on the adaptability of these scales across diverse populations, particularly in older adults and those with specific health conditions.