title: Assessment of depressive symptoms in deaf persons.
abstract: BACKGROUND
  Evidence suggests that Deaf people may have a greater prevalence of depressive symptoms. However, it is unclear whether commonly used written screening instruments are accurate with this population because of their unique cultural and linguistic factors.
  
  
  METHODS
  Deaf persons (n = 71) residing in southeastern Michigan.
  
  
  METHODS
  Subjects completed the Zung Self-Rated Depression Scale in both the written (ZSDS-W) and American Sign Language (ZSDS-S) formats and the Hamilton Depression Scale (HAM-D) in American Sign Language in counterbalanced order, followed by a Test Of Reading Comprehension (TORC). They also provided extensive data on demographic, hearing loss, language use, social and health care use variables.
  
  
  RESULTS
  Mean subject age was 52 years, 63% of subjects were women, 95% were Caucasian, and 47% were married (87% to another deaf/hard of hearing person). Thirty percent had a college degree and 20% had less than a 10th grade education. The ZSDS-W and ZSDS-S scores were highly correlated (r = +0.79), although the mean ZSDS-W score was 2.8 points higher (P = .001). The ZSDS-S correlated more highly (r = 0.80) with the HAM-D than the ZSDS-W (r = 0.71). There was a significant interaction effect (P < .001) such that the ZSDS-W and HAM-D were significantly associated among higher literacy subjects (beta = 0.80, P < .001) but not lower literacy subjects (beta = 0.20, P = .183). There were no other significant associations between depression scores and numerous demographic, educational, hearing loss, social or language variables.
  
  
  CONCLUSIONS
  Compared with the conventional ZSDS-W, the ZSDS-S more accurately assesses depression severity among deaf persons with lower English literacy. However, given the greater sensitivity of the ZSDS-W and the practical barriers to ZSDS-S in physician practices, further research should determine which modality is best for routine depression screening.
authors.affiliation: University of Michigan Health System, Department of Family Medicine, Ann Arbor, MI, USA. pzaz@umich.edu
authors.forename: Philip
authors.initials: P
authors.lastname: Zazove
authors.forename: Helen E
authors.initials: HE
authors.lastname: Meador
authors.forename: James E
authors.initials: JE
authors.lastname: Aikens
authors.forename: Donald E
authors.initials: DE
authors.lastname: Nease
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Gorenflo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003638:Deafness / Q000150:complications*; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D011581:Psychological Tests; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012813:Sign Language