Email: ua. Although the factor structure of the GSMD has been reported in non-PCa samples, it has not been determined for this group of men. Two samples of PCa patients were recruited, from Australia and from the United Kingdom and all patients received the GSMD individually, plus a background questionnaire. Two-factor solutions were identified for each of the two samples. The Australian sample was characterized by changes in emotional and somatic function, followed by depressed mood.
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APA Chodkiewicz, J. Harvard Chodkiewicz, J. Vancouver Chodkiewicz J. Reasons for the interest in the issue mainly include the differences with respect to the diagnosis of depression, considerably more common in women as compared to the significantly larger number of suicidal deaths in men . The experience of the early diagnosis and treatment of depression and suicide prevention program on the island of Gotland Sweden also proved to be relevant.
The program focused on the typical symptoms of depression and resulted in positive changes regarding the frequency of suicidal behaviour and the diagnosis and treatment of depression in women, little changed in this respect in the case of men.
The main differences were perceived in the domination of atypical symptoms in many depressed men, especially anger, irritability, aggressive and risky behaviour as well as use of alcohol and other psychoactive substances instead of depressed mood and lack of activity [e. Rutz [7, 8]. The method was initially conceived as a screening tool designed for primary care physicians.
It gained great popularity; it is used in numerous scientific studies and has been adapted in several countries, such as Italy, China and Iceland . For these reasons, it was decided to carry out the Polish validation of the tool, which was the aim of the present study.
The scale consists of 13 statements describing the depressive symptoms of the people examined a month before. The items relate to both the typical symptoms of depression, such as anxiousness, sleep disorders, fatigue, difficulty in making decisions, tendency to self-pity and the atypical symptoms, i.
The last item refers to the occurrence similar tendencies in the family members, i. The scale, in its original version, consists of two subscales: the distress scale items 1, 2, 5, 8, 9, 10, 12 and the depression scale 3, 4, 6, 7, 11, The overall result is in the range from 0 to 39 points. The authors adopted the following interpretation of the results of the full scale: points — no signs of depression; — possible depression, appropriate treatment should be considered; — depression, most likely treatment is necessary including pharmacological [7, 8].
Development of the Polish version of the GDMS scale and statistical analyses After obtaining permission from the author for the adaptation of the scale, two translators translated it from English into Polish. Then, two other translators including a certified court translator back-translated the scale.
After comparing the received versions, the final version was prepared. The reliability and validity of the method were calculated. The theoretical validity of the scale was verified by the exploratory and confirmatory factor analyses. The exploratory factor analysis EFA was used by oblimin rotation to verify the structure of the scale factors, supported the confirmatory factor analysis CFA to determine the proper match to the model data obtained in the exploratory analysis.
The convergent validity of the method was also estimated through the analysis of correlation coefficients between its results and those of some selected psychometric tools. What is more, the mean results obtained on the scale were compared in a group of healthy men diagnosed with depression and alcohol dependence. The subjects The study involved a total of men. They included with neither current nor past diagnosed mental disorders nor serious somatic illnesses.
The study was anonymous; the patients were informed about its purpose and were allowed to resign at any time.
The method allows to assess the general state of mental health and its 4 dimensions: somatic symptoms, anxiety and insomnia, social dysfunction and depressive symptoms. Psychic pain, defined as a strong sense of mental anguish, displays close correlations with both depression and suicidal tendencies [e.
The Polish versions of the tools used were characterised by satisfactory indicators of reliability and validity. RESULTS Theoretical accuracy — structure factor validity of the scale In order to verify the internal structure of the tool, both the exploratory factor analysis and confirmatory analysis were used.
The first was subject to the exploratory analysis; the second was subject to the confirmatory one. Before the analyses, the adequacy of selection was verified, using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy. Factorial structure of the scale The exploratory factor analysis with oblimin rotation and Kaiser normalisation enhanced by the scree test showed that the Polish version of the scale has a two-factor structure, i.
In total, both factors explained Analysing Figure I, it can be seen that all of the items positively charge factor component one; the nature of this factor is best seen in items 1, 5 and 10 the ones most to the right in the figure. In turn, the second factor positively charges items 13, 11, 12 to the greatest extent.
However, if the criterion of 0. This analysis supports the one-factor structure of the scale. Subsequently, it was decided to test the one-factor solution. This confirms the conclusion that the one-factor structure is more suited to the Polish version of the scale. The CFA results are presented in Table 1. Reliability The reliability of the tool was calculated by estimating the internal consistency and calculating the discriminating power of the items. Since the coefficients obtained exceeded the recommended value of 0.
The next step was to analyse the discriminating power of the questionnaire items. The discriminating power of the analysed items of the scale is satisfactory: the correlation of the items with the overall result was except for statement 13 from 0. The weakest correlation 0. It should be noted that item 13 was also the only item in the confirmatory analysis, in which the factor charge was below 0. Table 1. External validity The external validity of the adapted method was based on the analysis of the correlation between its results and those obtained using the Beck Depression Inventory, GHQ Scale depression subscale and the Scale of Psychache.
The results of the correlation Pearson r are presented in Table 3. The comparison was made in the group of healthy subjects and those diagnosed with depression. As indicated in Table 3, the validated method is characterised by a satisfactory external validity.
Noteworthy is the fact that stronger correlations between the variables were observed in patients diagnosed with depression, as compared to the healthy subjects. Normalization At the last stage, comparison was performed for the results obtained in the GDMS in three groups of men — healthy, addicted to alcohol and treated for depression.
The results of the applied analysis of variance are presented in Table 4. As shown in Table 4, statistically significant differences were observed between all of the analysed groups; the healthy men obtained the lowest scores, and those with depression diagnosed — the highest.
It was also decided to see what percentage of the men surveyed in all groups meets the criteria for possible depression score over 13 points, according to the instructions and depression score over 27 points. All of the obtained results indicate that the GDMS well discriminates the studied groups of subjects.
The exploratory and conformational factor analyses used indicate that the Polish version of the method is characterised by a one-factor structure. Similar conclusions were obtained during adaptation of the tool in Italy; the Italian version also presented a one-factor structure, and item 13 showed the weakest correlations with the general factor .
The two-factor structure of the scale was not confirmed in the Chinese studies, either, in which the analogous item 13 showed the weakest correlations with the general factor, but the correlation coefficient was higher there than the one in the Polish version 0.
The information on the disorders in the family of origin is undoubtedly important diagnostically and therapeutically; however, it applies to a different subject area than the currently occurring depressive symptoms. In addition, patients may have incomplete knowledge on the disorders or may not want to disclose them.
The adapted method shows a strong correlation with other methods for the diagnosis of depression BDI, GHQ 28 — depression subscale , confirming its satisfactory validity. Other studies used other comparative tools, for example, the Beck Hopelessness Scale BHS , also showing significant correlations [among others 13]. The GDMS mean results differed significantly in the case of the healthy men, men with alcohol dependence and those diagnosed with depression.
A different result was obtained in Germany during a study on a large group of young men mean age This difference may be due to the increased impulsivity and tendency to risky behaviour and mood swings among young men, as compared with the elderly ones.
In turn, the studies of Zierau et al. Comparing the results obtained in the studies conducted among the treated men with depressive disorders, it can be seen that they obtained the mean GDMS scores in the range from It also turned out that between Thus, the results are somewhat lower This discrepancy may be due, inter alia, to the heterogeneity of the persons with depression, the small size of the Polish sample and the fact that these patients may be at different stages of the treatment of depressive disorders.
The issue of the intensity of the atypical symptoms among men treated for depression therefore requires further, in-depth analyses. Future studies should also verify the correlation between the GDMS and suicidal tendencies as there is data indicating that the results of the scale can be a sensitive predictor of the trends [13, 22].
The present study has its limitations. First of all, the basic validation calculations were performed on healthy men, and they would need to be performed in the group of men with depression, too, as in the Italian or Chinese studies [12, 13].
What is more, only men were subject to the studies, while some data indicates no differences on the scale between men and women [13, 24]. Is it possible that we are not dealing with male depression, but with depression with a clinical picture different than the typical, regardless of gender? The answer to this question should be given in future studies on large groups of both women and men. In conclusion, despite the above-mentioned concerns, it can be stated that the Polish version of the GDMS has fully satisfactory psychometric properties.
The method can be recommended for use both in research and screening studies. In the latter case, it seems desirable to draw attention both to the total score as well as to the analysis of the responses to the items. The items, e.
In contrast, calculating and analysing the two subscales suggested in the original scale — distress and depression — seems to be of little use. The method is short, understandable and easy to use, so it can help in isolating persons who may experience depression and related suicidal tendencies. Rutza [7, 8]. Wyniki CFA przedstawia tabela 1. Wyniki korelacji r Pearsona przedstawia tabela 3. Wyniki zastosowanej analizy wariancji przedstawia tabela 4.
Z kolei badania Zierau i wsp. Pytania te, np.
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The Gotland Male Depression Scale: a validity study in patients with alcohol use disorder.