The validity of the Dutch K10 and extended K10 screening scales for depressive and anxiety disorders

Donker, Tara; Comijs, Hannie; Cuijpers, Pim; Terluin, Berend; Nolen, Willem; Zitman, Frans; Penninx, Brenda

doi:10.1016/j.psychres.2009.01.012

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Volume 176, Issue 1 , Pages 45-50, 30 March 2010

The validity of the Dutch K10 and extended K10 screening scales for depressive and anxiety disorders

Tara Donker
- Department of Clinical Psychology, EMGO Institute, VU University Amsterdam, The Netherlands
- Corresponding author. VU University, Department of Clinical Psychology, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Tel.: +31 20 5988 265; fax: +31 20 5988 758.
Hannie Comijs
- Department of Psychiatry, EMGO-Institute, VU University Medical Center, Amsterdam, The Netherlands
Pim Cuijpers
- Department of Clinical Psychology, EMGO Institute, VU University Amsterdam, The Netherlands
Berend Terluin
- Department of General Practice, EMGO-Institute, VU University Medical Center, Amsterdam, The Netherlands
Willem Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Frans Zitman
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
Brenda Penninx
- Department of Psychiatry, EMGO-Institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands

Received 5 June 2008; received in revised form 19 November 2008; accepted 5 January 2009.

Abstract

The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10, extended with five additional questions focusing on core anxiety symptoms, and were evaluated with the WHO Composite International Diagnostic Interview (CIDI lifetime version 2.1) to assess DSM-IV disorders (major depressive disorder, dysthymia, generalized anxiety disorder, social phobia, panic disorder, agoraphobia). Reliability (Cronbach's α) of the Dutch K10 was 0.94. Based on Receiver Operating Characteristics (ROC) analysis, the area under the curve (AUC) for the K10 for any depressive and/or anxiety disorder was found to be 0.87. The extended questions on the EK10 significantly improved the detection of anxiety disorders in particular. With a cut-off point of 20, the K10 reached a sensitivity of 0.80 and a specificity of 0.81 for any depressive and/or anxiety disorder. For the EK10, a cut-off point of 20 and/or at least one positive answer on the additional questions provided a sensitivity of 0.90 and a specificity of 0.75 for detecting any depressive and/or anxiety disorder. The Dutch version of the K10 is appropriate for screening depressive disorders in primary care, while the EK10 is preferred in screening for both depressive and anxiety disorders.

Keywords: Screening questionnaire, Depression, Anxiety, Sensitivity, Specificity