A cultural validation of the Chinese version of the Multidimensional Depression Assessment Scale (MDAS) in clinically depressed patients in Inner Mongolia

Introduction: Depression symptoms and assessment in China are influenced by unique cultural values of collectivism and by social-political factors specific to China. This study validated the Chinese version of the 52-item Multidimensional Depression Assessment Scale (MDAS) with clinically depressed patients in Inner Mongolia. The study sought to examine the psychometric properties of the MDAS and understand the construct of depression in a specific collectivistic cultural context using a scale with comprehensive dimensions of depressive symptoms in the emotional, cognitive, somatic and interpersonal domains. Method: A total of 171 clinically depressed participants in Inner Mongolia completed the Chinese versions of the MDAS and the Beck Depressive Inventory (BDI). The reliability and validity of the MDAS were tested, and an exploratory factor analysis (EFA) was conducted on the MDAS to examine the underlying structure of the measure. The MDAS and BDI were compared in terms of sensitivity and reactivity on the basis of the cut-off value of BDI. Results: The Chinese-MDAS was found to have good psychometric properties, including high Cronbach’s alphas for the total scale and for each subscale (0.90–0.97), indicating good reliability, as well as a high and significant correlation with the BDI (r = 0.72; p <.001), suggesting good validity. The factor analysis indicated the emergence of a salient factor of interpersonal symptoms in Chinese depressed patients, suggesting the importance of interpersonal symptoms in Chinese depressed individuals. A cut-off value of 118.5 with high sensitivity and specificity was found on the MDAS based on the cut-off value of the BDI. Conclusion: The Chinese-MDAS demonstrated good psychometric properties among depressed individuals in Inner Mongolia. This study paves the way for the measure’s further development and cultural adaptation in a Chinese depressed population. 

Qualitative analysis of dysfunctional attitudes in Chinese persons suffering from depression

Objectives: To explore the characteristics of dysfunctional attitudes among Chinese depressed persons. Participants and Methods: Semi-structured interviews were conducted on 20 Chinese depressed participants, with dysfunctional attitudes pertaining to themes concerning: 'vulnerability', 'need for approval', 'role performance within family hierarchy', 'familial harmony', 'relational harmony', 'imperatives', 'fate', 'face', 'fairness', and 'success- perfectionism'. Results: Themes related to interpersonal and family issues were dominant in their profile of dysfunctional attitudes. New themes such as 'face' and 'fate' were identified. Cultural influences contributing to these dysfunctional attitude characteristics were discussed. Conclusion: To enhance the treatment effectiveness and rehabilitation from cognitive behavioural programmes in Chinese subjects suffering from depression, culturally sensitive attitudes should be attended to. © 2007 Hong Kong College of Psychiatrists.link_to_subscribed_fulltex