D.L. Hare*, K. Meyer and H. McBurney.

Austin & Repatriation Medical Centre, Heidelberg, Vic.,  Herz-Zentrum, Bad Krozingen, Germany and La Trobe University, Vic

The Cardiac Depression Scale (CDS) was developed in Australian cardiac patients to reliably and sensitively measure "adjustment disorder with depressed mood", a well defined aspect (perhaps even the "bottom line") of quality of life. The aim of this study was to test the internal validity and reliability of a German language version of the CDS.

Methods: The 26 items of the CDS were translated into German with face validity reviewed by appropriate, experienced clinicians. Item numbers, presentation and scoring remained identical to the English language version. The CDS was administered to 114 German rehabilitation in-patients (98 male, 16 female; 60 CABG, 54 AMI, age 66.3 ± 8.7, range 35-85 years). Cronbach's alpha was calculated across all items to assess internal reliability. The 26 items were then subjected to a factor analysis using maximum likelihood factor extraction and oblimin oblique rotation to allow for non-orthogonal factors. Only factors with an eigen value (for total variance) of greater than one on the principal component solution were included and a significant loading of  >0.3 was required for inclusion of an item on a factor.

Results: Scores were normally distributed about a mean of 82.7 without skewness (range 32-141, SD 21.7). Cronbach's alpha for the 26 items in the scale was 0.89 indicating high reliability. The factor analysis identified exactly the same seven factors as the original English language version with a consistently high level of  internal reliability. No items were rejected because of insignificant loading on a factor.

Conclusions: Depressed mood is a well defined and robust aspect of quality of life. It now appears that it can be reliably measured across cultural and language differences, certainly in Germany, using the CDS.

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