title: Dimensionality and scale properties of the Edinburgh Depression Scale (EDS) in patients with type 2 diabetes mellitus: the DiaDDzoB study.
abstract: BACKGROUND
  Depression is a common complication in type 2 diabetes (DM2), affecting 10-30% of patients. Since depression is underrecognized and undertreated, it is important that reliable and validated depression screening tools are available for use in patients with DM2. The Edinburgh Depression Scale (EDS) is a widely used method for screening depression. However, there is still debate about the dimensionality of the test. Furthermore, the EDS was originally developed to screen for depression in postpartum women. Empirical evidence that the EDS has comparable measurement properties in both males and females suffering from diabetes is lacking however.
  
  
  METHODS
  In a large sample (N = 1,656) of diabetes patients, we examined: (1) dimensionality; (2) gender-related item bias; and (3) the screening properties of the EDS using factor analysis and item response theory.
  
  
  RESULTS
  We found evidence that the ten EDS items constitute a scale that is essentially one dimensional and has adequate measurement properties. Three items showed differential item functioning (DIF), two of them showed substantial DIF. However, at the scale level, DIF had no practical impact. Anhedonia (the inability to be able to laugh or enjoy) and sleeping problems were the most informative indicators for being able to differentiate between the diagnostic groups of mild and severe depression.
  
  
  CONCLUSIONS
  The EDS constitutes a sound scale for measuring an attribute of general depression. Persons can be reliably measured using the sum score. Screening rules for mild and severe depression are applicable to both males and females.
authors.affiliation: Department of Medical Psychology & Neuropsychology, Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands.
authors.forename: Evi S A
authors.initials: ES
authors.lastname: de Cock
authors.forename: Wilco H M
authors.initials: WH
authors.lastname: Emons
authors.forename: Giesje
authors.initials: G
authors.lastname: Nefs
authors.forename: Victor J M
authors.initials: VJ
authors.lastname: Pop
authors.forename: François
authors.initials: F
authors.lastname: Pouwer
mesh_terms: D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011287:Prejudice; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D015203:Reproducibility of Results