Validity and Reliability of the Korean Version of Gotland Male Depression Scale

Abstract

Objective: Despite lower depression rates in men than in women, men's suicide rates are significantly higher, suggesting potential gaps in depression screening. Rutz et al. developed the Gotland Male Depression Scale (GMDS), which includes symptoms commonly associated with male depression. This study was conducted to validate the Korean version of the GMDS (K-GMDS).

Methods: The K-GMDS, Patient Health Questionnaire-9 (PHQ-9), and outpatient records of 233 new patients at the outpatient psychiatry department of Catholic University Hospital in Daegu from February and May 2022 were retrospectively reviewed. Internal consistency was measured using Cronbach's α, and external validity was tested by analyzing the scale's correlation with the PHQ-9. The screening capacity of the K-GMDS was tested based on the receiver operating characteristic (ROC) curve, sensitivity, specificity, and overall accuracy.

Results: Of 233 patients, 42.6% (n=98) were classified to the depression group. Cronbach's α was 0.92, and external validity was established with a Pearson's correlation coefficient of 0.83 between the total score of the K-GMDS and the PHQ-9. While there were no significant differences in the area under the ROC curve between the K-GMDS and the PHQ-9, the K-GMDS had better sensitivity, specificity, and overall accuracy in screening depressive symptoms among men compared to the PHQ-9.

Conclusion: The K-GMDS exhibits satisfactory reliability and validity in psychiatric outpatient settings and outperforms the PHQ-9 in screening for depression among men. This study will be useful in developing male depression scales that are currently unavailable in South Korea.

Keywords: Depressive disorder; Gender characteristics; ROC curve; Suicide; Validation study.

Figure 1.

Flowchart of screening and classifying patients. K-GMDS, Korean version of the Gotland Male Depression Scale; PHQ-9, Patient Health Questionnaire-9.

Figure 2.

Correlation between the K-GMDS and the PHQ-9. K-GMDS, Korean version of the Gotland Male Depression Scale; PHQ-9, Patient Health Questionnaire-9.

Figure 3.

ROC curve for the K-GMDS and the PHQ-9 for all patients and each gender group. ROC, receiver operating characteristic; K-GMDS, Korean version of the Gotland Male Depression Scale; PHQ-9, Patient Health Questionnaire-9.