Psychometric Testing of the Chinese Version of the Clinically Useful Depression Outcome Scale in Patients with Diabetes

Thursday, 2 August 2012: 9:10 AM

Pei-Shan Tsai, PhD
Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

Learning Objective 1: describe the procedures used to examine the psychometric properties of an instrument.

Learning Objective 2: describe the validity and reliability of the Chinese version of the Clinically Useful Depression Outcome Scale.


The purpose of this study was to test the psychometric properties of the Clinically Useful Depression Outcome Scale (CUDOS) in Taiwanese diabetic patients.   


The CUDOS contains 18 items covering the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptoms of major depressive disorder and dysthymic disorder. Each item is scored a 5-point Likert scale (0 – 4) with a score ranging from 0 to 72. Following the standard translation-back translation procedure, the CUDOS was translated into Chinese. Internal consistency was examined by the Cronbach’s alpha. All participants filled out the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF), Taiwan Version, along with the CUDOS. To assess test-retest reliability, the participants were asked to fill out the CUDOS on a second occasion at a 7-day interval.


Included in the study were 153 diabetics, including 132 patients without and 21 patients with depression. The CUDOS scores were significantly different between patients with depression and those without (p < 0.001). The Cronbach’s alpha was 0.93 for the CUDOS. The test-retest correlation coefficient was 0.83. The CUDOS significantly and positively correlated to BDI-II (r = 0.88, p < 0.001) and BAI (r = 0.78, p < 0.001) and inversely correlated to the WHOQOL-BREF (r = -0.32, p < 0.001). The CUDOS score significantly and independently predicted quality of life after adjusting for possible confounders.


The Chinese version of the CUDOS demonstrated satisfactory reliability and validity for use in the Taiwanese diabetic patients.