Examining the utilisation and validity of the Depression Intensity Scale Circles (DISCs): A scoping review

The Depression Intensity Scale Circles (DISCs) is a visual self-report depression screening tool that has been designed specifically for people with moderate-to-severe cognitive or communicative impairment. This scoping review aimed to systematically map research on the DISCs, drawing conclusions about its reliability, validity, and utilization in research and clinical practice. A literature search from 2004 - July 2024 was conducted using 9 databases. Thirty-six sources met inclusion criteria of mentioning "Depression Intensity Scale Circles" in their abstract or full text (15 published literature, 12 grey literature, and 9 social media posts). Only three sources formally studied the psychometric properties of the DISCs. Taken together, their results suggested that the DISCs has stronger predictive validity than reported in previous systematic reviews. While promising, these results should be interpreted cautiously due to the limited research available. Despite limited research, we found that the DISCs continues to be recommended and included into guidelines for depression screening, especially in in-patient stroke settings in the UK. The need for further research into the psychometric properties of the DISCs is identified. The trade-off in clinical settings between psychometric validity and clinical utility when working with individuals with cognitive and communication impairments is highlighted.