The Symptom Checklist-core depression (SCL-CD6) scale: Psychometric properties of a brief six item scale for the assessment of depression

Linda L Magnusson Hanson; Hugo Westerlund; Constanze Leineweber; Reiner Rugulies; Walter Osika; Töres Theorell; Per Bech

doi:10.1177/1403494813500591

The Symptom Checklist-core depression (SCL-CD6) scale: Psychometric properties of a brief six item scale for the assessment of depression

Linda L Magnusson Hanson, Hugo Westerlund, Constanze Leineweber, Reiner Rugulies, Walter Osika, Töres Theorell, Per Bech

65 Citations (Scopus)

Abstract

AIMS: Major depressive disorders are common, with substantial impact on individuals/society. Brief scales for depression severity, based on a small number of characteristics all of which are necessary for diagnosis, have been recommended in self-reported versions for clinical work or research when aiming to quickly and accurately measure depression. We have examined psychometric properties of a brief 6-item version of the Symptom Checklist (SCL), the Symptom Checklist core depression scale (SCL-CD6) and aimed to identify a cut-point for epidemiological research.

METHODS: The psychometric evaluation of the SCL-CD6 was mainly performed by a Mokken analysis of unidimensionality in a random sample of 1476 residents in the Stockholm County, aged 18-64 years. The standardization of SCL-CD6 was based on ROC analysis, using the Major Depression Inventory as index of validity. Predictive validity was subsequently assessed using register data on hospital admissions and purchases of prescribed medications linked to a sample of 5985 participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH).

RESULTS: The SCL-CD6 obtained a coefficient of homogeneity of 0.70 by Mokken analysis, which indicates high unidimensionality and a meaningful dimensional measure of depression severity. By ROC we identified a score of 17 or higher (total range 0-24) as the best cut-point for major depression (sensitivity 0.68, specificity 0.98) which predicted subsequent purchases of antidepressants as well as hospitalisations with a depressive episode.

CONCLUSIONS: The SCL-CD6 was found a valid depression scale with higher unidimensionality than longer epidemiological instruments and thus particularly suitable for assessment in larger population surveys.

Original language	English
Journal	Scandinavian Journal of Public Health
Volume	42
Issue number	1
Pages (from-to)	82-88
Number of pages	7
ISSN	1403-4948
DOIs	https://doi.org/10.1177/1403494813500591
Publication status	Published - Feb 2014

Keywords

Adolescent
Adult
Checklist
Depressive Disorder
Depressive Disorder, Major
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Middle Aged
Psychiatric Status Rating Scales
Psychometrics
Reproducibility of Results
Severity of Illness Index
Sweden
Young Adult

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10.1177/1403494813500591

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The Symptom Checklist-core depression (SCL-CD6) scale : Psychometric properties of a brief six item scale for the assessment of depression. / Magnusson Hanson, Linda L; Westerlund, Hugo; Leineweber, Constanze et al.

In: Scandinavian Journal of Public Health, Vol. 42, No. 1, 02.2014, p. 82-88.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "The Symptom Checklist-core depression (SCL-CD6) scale: Psychometric properties of a brief six item scale for the assessment of depression",

abstract = "AIMS: Major depressive disorders are common, with substantial impact on individuals/society. Brief scales for depression severity, based on a small number of characteristics all of which are necessary for diagnosis, have been recommended in self-reported versions for clinical work or research when aiming to quickly and accurately measure depression. We have examined psychometric properties of a brief 6-item version of the Symptom Checklist (SCL), the Symptom Checklist core depression scale (SCL-CD6) and aimed to identify a cut-point for epidemiological research.METHODS: The psychometric evaluation of the SCL-CD6 was mainly performed by a Mokken analysis of unidimensionality in a random sample of 1476 residents in the Stockholm County, aged 18-64 years. The standardization of SCL-CD6 was based on ROC analysis, using the Major Depression Inventory as index of validity. Predictive validity was subsequently assessed using register data on hospital admissions and purchases of prescribed medications linked to a sample of 5985 participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH).RESULTS: The SCL-CD6 obtained a coefficient of homogeneity of 0.70 by Mokken analysis, which indicates high unidimensionality and a meaningful dimensional measure of depression severity. By ROC we identified a score of 17 or higher (total range 0-24) as the best cut-point for major depression (sensitivity 0.68, specificity 0.98) which predicted subsequent purchases of antidepressants as well as hospitalisations with a depressive episode.CONCLUSIONS: The SCL-CD6 was found a valid depression scale with higher unidimensionality than longer epidemiological instruments and thus particularly suitable for assessment in larger population surveys.",

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author = "{Magnusson Hanson}, {Linda L} and Hugo Westerlund and Constanze Leineweber and Reiner Rugulies and Walter Osika and T{\"o}res Theorell and Per Bech",

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AU - Westerlund, Hugo

AU - Leineweber, Constanze

AU - Rugulies, Reiner

AU - Osika, Walter

AU - Theorell, Töres

AU - Bech, Per

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N2 - AIMS: Major depressive disorders are common, with substantial impact on individuals/society. Brief scales for depression severity, based on a small number of characteristics all of which are necessary for diagnosis, have been recommended in self-reported versions for clinical work or research when aiming to quickly and accurately measure depression. We have examined psychometric properties of a brief 6-item version of the Symptom Checklist (SCL), the Symptom Checklist core depression scale (SCL-CD6) and aimed to identify a cut-point for epidemiological research.METHODS: The psychometric evaluation of the SCL-CD6 was mainly performed by a Mokken analysis of unidimensionality in a random sample of 1476 residents in the Stockholm County, aged 18-64 years. The standardization of SCL-CD6 was based on ROC analysis, using the Major Depression Inventory as index of validity. Predictive validity was subsequently assessed using register data on hospital admissions and purchases of prescribed medications linked to a sample of 5985 participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH).RESULTS: The SCL-CD6 obtained a coefficient of homogeneity of 0.70 by Mokken analysis, which indicates high unidimensionality and a meaningful dimensional measure of depression severity. By ROC we identified a score of 17 or higher (total range 0-24) as the best cut-point for major depression (sensitivity 0.68, specificity 0.98) which predicted subsequent purchases of antidepressants as well as hospitalisations with a depressive episode.CONCLUSIONS: The SCL-CD6 was found a valid depression scale with higher unidimensionality than longer epidemiological instruments and thus particularly suitable for assessment in larger population surveys.

AB - AIMS: Major depressive disorders are common, with substantial impact on individuals/society. Brief scales for depression severity, based on a small number of characteristics all of which are necessary for diagnosis, have been recommended in self-reported versions for clinical work or research when aiming to quickly and accurately measure depression. We have examined psychometric properties of a brief 6-item version of the Symptom Checklist (SCL), the Symptom Checklist core depression scale (SCL-CD6) and aimed to identify a cut-point for epidemiological research.METHODS: The psychometric evaluation of the SCL-CD6 was mainly performed by a Mokken analysis of unidimensionality in a random sample of 1476 residents in the Stockholm County, aged 18-64 years. The standardization of SCL-CD6 was based on ROC analysis, using the Major Depression Inventory as index of validity. Predictive validity was subsequently assessed using register data on hospital admissions and purchases of prescribed medications linked to a sample of 5985 participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH).RESULTS: The SCL-CD6 obtained a coefficient of homogeneity of 0.70 by Mokken analysis, which indicates high unidimensionality and a meaningful dimensional measure of depression severity. By ROC we identified a score of 17 or higher (total range 0-24) as the best cut-point for major depression (sensitivity 0.68, specificity 0.98) which predicted subsequent purchases of antidepressants as well as hospitalisations with a depressive episode.CONCLUSIONS: The SCL-CD6 was found a valid depression scale with higher unidimensionality than longer epidemiological instruments and thus particularly suitable for assessment in larger population surveys.

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KW - Middle Aged

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KW - Psychometrics

KW - Reproducibility of Results

KW - Severity of Illness Index

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JO - Acta socio-medica Scandinavica

JF - Acta socio-medica Scandinavica

IS - 1

ER -

The Symptom Checklist-core depression (SCL-CD6) scale: Psychometric properties of a brief six item scale for the assessment of depression

Abstract

Keywords

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