Detecting Depression in People Living with HIV in South Africa: The Factor Structure and Convergent Validity of the South African Depression Scale (SADS)

• DOI: 10.1007/s10461-020-02787-4
• Publication Date: 2020-01-21T06:03:56Z
• Authors: L. S. Andersen; J. A. Joska; J. F. Magidson; C. O’Cleirigh; J. S. Lee; A. Kagee; J. A. Witten; S. A. Safren
• Keywords: Psychiatric Status Rating Scales; South Africa; 03 medical and health sciences; 0302 clinical medicine; Psychometrics; Depression; Humans; Reproducibility of Results; HIV Infections; 3. Good health

Screening measures for depression developed in high-income countries have not always demonstrated strong psychometric properties in South Africa and with people living with HIV (PLWH). The present study explored the psychometric properties of the 16-item South African Depression Scale (SADS) comprised of idioms of distress specific to isiXhosa culture in PLWH. The SADS was administered to 137 Xhosa-speaking PLWH who met diagnostic criteria for major depressive disorder (MDD) together with the Hamilton Depression Scale (HAM-D) and the Center for Epidemiological Studies Depression Scale (CES-D). We conducted exploratory factor analysis, correlation, and reliability statistics. Four factors of the SADS emerged: Sadness, lethargy/burdened, anhedonia/withdrawal, and cognitive/somatic. All factors correlated significantly with the HAM-D and CES-D. Internal consistency of the overall measure was high (α = .89). The SADS promises to be a robust measure of depression in isiXhosa-speaking PLWH in South Africa likely due to the inclusion of local idioms of distress.