Development of the EURO–D scale – a European Union initiative to compare symptoms of depression in 14 European centres

TLDR

An 11‑country European collaboration of 14 population‑based surveys included 21 724 participants aged ≥ 65 years, most of whom were assessed with the Geriatric Mental State, though other measures were also employed. The study aimed to derive a common depression symptom scale, the EURO‑D, to enable comparison of risk‑factor profiles across centres. Common items were identified across instruments, and algorithms for mapping them to the GMS were developed by item correspondence or expert opinion, yielding a 12‑item scale that was evaluated for internal consistency, criterion validity, and factor‑analytic uniformity. The EURO‑D demonstrated internal consistency and captured its parent instrument’s essence, with a two‑factor structure separating affective suffering and motivational symptoms, and it should allow valid comparison of risk‑factor associations across centres despite residual between‑centre variation.

Abstract

Background In an 11-country European collaboration, 14 population-based surveys included 21 724 subjects aged ⩾65 years. Most participating centres used the Geriatric Mental State (GMS), but other measures were also used. Aims To derive from these instruments a common depression symptoms scale, the EURO–D, to allow comparison of risk factor profiles between centres. Method Common items were identified from the instruments. Algorithms for fitting items to GMS were derived by observation of item correspondence or expert opinion. The resulting 12-item scale was checked for internal consistency, criterion validity and uniformity of factor-analytic profile. Results The EURO–D is internally consistent, capturing the essence of its parent instrument. A two-factor solution seemed appropriate: depression, tearfulness and wishing to die loaded on the first factor (affective suffering), and loss of interest, poor concentration and lack of enjoyment on the second (motivation) Conclusions The EURO–D scale should permit valid comparison of risk-factor associations between centres, even if between-centre variation remains difficult to attribute. A two-factor solution seemed appropriate: depression, tearfulness and wishing to die loaded on the first factor (affective suffering), and loss of interest, poor concentration and lack of enjoyment on the second (motivation) Conclusions The EURO–D scale should permit valid comparison of risk-factor associations between centres, even if between-centre variation remains difficult to attribute.