Validity and Reliability of the Turkish Version of the Cardiac Depression Scale

Validity and Reliability Study of the Turkish Long and Short Forms of the Cardiac Depression Scale

The Cardiac Depression Scale (CDS) in both its long and short forms has been validated in various languages and populations and is used to detect depression in individuals with cardiovascular disease (CVD). However, there is no validity and reliability study of the CDS for CVD patients in the Turkish population available in the literature, which prevents its use in Turkish population. The study aims to test the validity and reliability of the Turkish version of long and short forms of the CDS in Turkish individuals with CVD.

CVDs are among the leading causes of death worldwide and in Türkiye. Studies have shown that the prevalence of depression is higher among individuals with CVD compared to the general population. For example, higher rates of depression have been reported in patients who have undergone coronary bypass surgery, individuals who experienced myocardial infarction, and those with angina pectoris. Depression itself can be a cause of CVD, while CVD can also trigger depressive symptoms.

The presence of depression in individuals with CVD is associated with diverse adverse outcomes including mortality. Therefore, routine depression screening is recommended for individuals with CVD. Many scales are currently used in clinical practice for depression screening. The CDS was specifically developed in 1996 for individuals with CVD and remains the only scale in the literature designed for this purpose. The CDS consists of 26 self-administered items and is used to identify and assess the severity of depressive symptoms, including emotional, cognitive, and somatic characteristics. Originally developed in English in Australia, the scale has undergone validity and reliability studies for individuals with different CVD conditions across various languages and cultures. The CDS takes approximately five minutes to administer and score, and demonstrates robust psychometric properties in distinguishing mild, moderate, and severe depression. CDS scores range from 26 to 182 with higher scores indicating more severe depressive symptoms. A score of 95 or higher on the CDS can detect major depression in individuals with CVD with 85% specificity and 97% sensitivity.

Due to constraints such as time, resources, and personnel in clinical practice, two shorter forms of the CDS have been developed, each consisting of five items derived from the original scale. These short forms have also been validated in English for different CVD populations. However, no validity or reliability study of the CDS, in either its long or short forms, has been studied in Turkish population. Furthermore, the short forms of the CDS have not undergone validity and reliability analyses in any language other than English.

Inclusion Criteria:

• Aged 18 or older and providing written consent to participate in the study
• Diagnosed with any cardiovascular disease (coronary artery disease, peripheral artery disease, cardiomyopathy, heart failure, valve diseases, arrhythmia) and in a stable condition
• No physical and/or mental condition that would prevent completing the scales
• Literate in Turkish

Exclusion Criteria:

• Individuals who do not meet the inclusion criteria will be excluded.
• Participants who are found to have incomplete responses to the scale questions after being included in the study, as well as those who choose to withdraw from the study voluntarily, will be removed.