Validation of the Korean version of the Depression in Old Age Scale (DIA-S) and comparison with other depression screening questionnaires used in elderly patients in medical settings
Young-Eun Jung 1, Moon-Doo Kim 1*, Won-Myong Bahk 2, Young Sup Woo 2, Beomwoo Nam 3, Jeong Seok Seo 3, Sae-Heon Jang 4, Hyung-Mo Sung 5, In Hee Shim 6, Bo-Hyun Yoon 7, Ji Sun Kim 8, Young-Joon Kwon 8
1Department of Psychiatry, School of Medicine, Jeju National University, Republic of Korea , 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Republic of Korea, 3Department of Psychiatry, School of Medicine, Konkuk University, Republic of Korea, 4Department of Psychiatry, Bongseng Memorial Hospital, Republic of Korea, 5Department of Psychiatry, Gumi CHA Medical Center, CHA University, Republic of Korea, 6Department of Psychiatry, Cancer Center, Dongnam Institute of Radiological & Medical Sciences, Republic of Korea, 7Department of Psychiatry, Naju National Hospital, Republic of Korea, 8Department of Psychiatry, Chunan Soonchunhyang Hospital, Soonchunhyang university, Republic of Korea
Received: January 31, 2018; Revised: February 27, 2018; Accepted: March 2, 2018; Published online: March 2, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: The Depression in Old Age Scale (DIA-S) is a new screening tool for assessing depression in the elderly. The primary aims of this study were to describe the validation of the Korean version of the DIA-S (K-DIA-S) and to compare its validity with that of other depression screening questionnaires used in elderly outpatients in medical settings.
Method: A total of 385 elderly outpatients completed the K-DIA-S and underwent the Mini International Neuropsychiatric Interview to diagnose depressive disorders. Other measures included the 15-item short form of the Geriatric Depression Scale (SGDS), the 9-item depression module of the Patient Health Questionnaire (PHQ-9), and the Montgomery–Asberg Depression Scale (MADRS). Reliability and validity tests, an optimal cutoff point estimate, and receiver operating characteristic (ROC) curve analysis were performed to investigate the diagnostic validity of the K-DIA-S. Areas under the curves (AUCs) for the K-DIA-S, SGDS, and PHQ-9 were compared statistically.
Results: The K-DIA-S showed good internal consistency and strong correlations with the SGDS (r = .853), PHQ-9 (r = .739), and MADRS (r = .772). The cut-off point of the K-DIA-S that can be recommended for screening depressive symptoms was a score of 4. For “any depressive disorder”, the AUC (standard error) for the K-DIA-S was 0.896 (0.015), which was significantly larger than that for the PHQ-9 (P = .033).
Conclusions: The present findings suggest that the K-DIA-S has good psychometric properties and is a valid and reliable tool for assessing depressive symptoms in elderly populations and medically ill patients.
Keywords: Depression in Old Age Scale (DIA-S), validation, Korean, elderly, depressive disorder


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