Validity and Reliability of the Turkish Version of the Cardiac Depression Scale (TURK-CDS)

April 9, 2026 updated by: Selcuk OZTURK, Kırıkkale University

Validity and Reliability Study of the Turkish Long and Short Forms of the Cardiac Depression Scale

The Cardiac Depression Scale (CDS) in both its long and short forms has been validated in various languages and populations and is used to detect depression in individuals with cardiovascular disease (CVD). However, there is no validity and reliability study of the CDS for CVD patients in the Turkish population available in the literature, which prevents its use in Turkish population. The study aims to test the validity and reliability of the Turkish version of long and short forms of the CDS in Turkish individuals with CVD.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

CVDs are among the leading causes of death worldwide and in Türkiye. Studies have shown that the prevalence of depression is higher among individuals with CVD compared to the general population. For example, higher rates of depression have been reported in patients who have undergone coronary bypass surgery, individuals who experienced myocardial infarction, and those with angina pectoris. Depression itself can be a cause of CVD, while CVD can also trigger depressive symptoms.

The presence of depression in individuals with CVD is associated with diverse adverse outcomes including mortality. Therefore, routine depression screening is recommended for individuals with CVD. Many scales are currently used in clinical practice for depression screening. The CDS was specifically developed in 1996 for individuals with CVD and remains the only scale in the literature designed for this purpose. The CDS consists of 26 self-administered items and is used to identify and assess the severity of depressive symptoms, including emotional, cognitive, and somatic characteristics. Originally developed in English in Australia, the scale has undergone validity and reliability studies for individuals with different CVD conditions across various languages and cultures. The CDS takes approximately five minutes to administer and score, and demonstrates robust psychometric properties in distinguishing mild, moderate, and severe depression. CDS scores range from 26 to 182 with higher scores indicating more severe depressive symptoms. A score of 95 or higher on the CDS can detect major depression in individuals with CVD with 85% specificity and 97% sensitivity.

Due to constraints such as time, resources, and personnel in clinical practice, two shorter forms of the CDS have been developed, each consisting of five items derived from the original scale. These short forms have also been validated in English for different CVD populations. However, no validity or reliability study of the CDS, in either its long or short forms, has been studied in Turkish population. Furthermore, the short forms of the CDS have not undergone validity and reliability analyses in any language other than English.

Study Type

Observational

Enrollment (Actual)

360

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Kırıkkale, Turkey (Türkiye)
        • Kırıkkale University Faculty of Medicine

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of individuals with stable CVD who are outpatients at the cardiology clinics of Kırıkkale University Faculty of Medicine.

Description

Inclusion Criteria:

  • Aged 18 or older and providing written consent to participate in the study
  • Diagnosed with any cardiovascular disease (coronary artery disease, peripheral artery disease, cardiomyopathy, heart failure, valve diseases, arrhythmia) and in a stable condition
  • No physical and/or mental condition that would prevent completing the scales
  • Literate in Turkish

Exclusion Criteria:

  • Individuals who do not meet the inclusion criteria will be excluded.
  • Participants who are found to have incomplete responses to the scale questions after being included in the study, as well as those who choose to withdraw from the study voluntarily, will be removed.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Participants with CVDs
The study cohort includes participants with stable cardiovascular disease (CVD) condition who apply to outpatient cardiology clinics of Kırıkkale University Faculty of Medicine.
Other: Sociodemographic Data Form
After inquiring about participants' sociodemographic characteristics, such as name, contact information, age, gender, marital status, education level, income, and place of residence, measurements of height, weight, and waist circumference will be obtained. Then, participants' CVD, psychiatric and other medical conditions, CVD risk factors, health history, and medications they are using will be queried. This information will be recorded in the sociodemographic data form. The sociodemographic data form has been prepared by the researchers.
Other: Short Form Health Survey
SF-36 is a self-assessment scale and can be completed in five minutes. SF-36 can evaluate both the negative and positive aspects of health. The scale consists of 36 items which are used to assess different health dimensions in 8 subscales: Physical functioning (10 items), social functioning (2 items), role limitations due to physical problems (4 items), role limitations due to emotional problems (3 items), mental health (5 items), energy/vitality (4 items), pain (2 items), and general health perception (5 items).
Other: Hospital Anxiety and Depression Scale
The HADS was designed in 1983 to identify anxiety and depression in individuals with physical illnesses. The HADS is a self-reported scale consisting of seven items each for the anxiety and depression subscales. Each item is scored from 0 to 3, and the total score for the anxiety and depression subscales is 21 points. The overall HADS score is obtained by summing the points from both subscales. A total subscale score between 0-7 indicates a normal test result, 8-10 indicates mild anxiety or depression, 11-15 indicates moderate anxiety or depression, and 16-21 indicates severe anxiety or depression. Higher scores represent higher levels of anxiety or depression, and the total HADS score reflects an overall measure of psychological distress. The survey can be completed in 2-5 minutes.
Other: Illness Intrusiveness Ratings Scale
The IIRS is an easy-to-administer scale designed to predict the psychosocial impact of chronic illness and to document and compare the effectiveness of therapeutic interventions. It consists of 13 questions which are completed by the patient. The scale measures how the limitations imposed by chronic and life-threatening diseases hinder participation in regular activities across 13 important aspects of life: Health, diet, work, active recreation (sports), passive recreation (reading, listening to music), finances, relationships with partners, sexual life, family relationships, other social relationships, self-expression/development, religious expression, and community and civic participation.
Other: Cardiac Depression Scale
CDS was designed to identify depression in individuals with CVDs. It consists of 26 items across 7 subscales. The subscales address issues such as sleep, uncertainty, mood, hopelessness, immobility, anhedonia, and cognition. The CDS is rated on a 7-point Likert scale, with seven items being reverse-coded. Based on patient feedback and clinical experience, two short forms were developed, each consisting of five questions. Both short forms showed good consistency with the original CDS. The first short form includes questions from the original CDS numbered 12, 24, 21, 10, and 9. The second short form includes questions from the original CDS numbered 12, 4, 25, 21, and 7.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Depression
Time Frame: Baseline
The primary outcome measure in the study is depression, as determined by the Cardiac Depression Scale (CDS), while other scales and participant demographic data will be considered as independent variables. CDS scores range from 26 to 182, with higher scores indicating more severe depressive symptoms. A score of 95 or higher on the CDS can detect major depression in individuals with CVD with 85% specificity and 97% sensitivity.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kırıkkale University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 11, 2025

Primary Completion (Actual)

November 1, 2025

Study Completion (Actual)

January 1, 2026

Study Registration Dates

First Submitted

February 11, 2025

First Submitted That Met QC Criteria

February 15, 2025

First Posted (Actual)

February 20, 2025

Study Record Updates

Last Update Posted (Actual)

April 14, 2026

Last Update Submitted That Met QC Criteria

April 9, 2026

Last Verified

February 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025.01.11

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

All IPD collected throughout the study period will be shared.

IPD Sharing Supporting Information Type

  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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