Translation, validation and cross-cultural adaptation of the geriatric depression scale (GDS-30) for utilization amongst speakers of Malayalam; the regional language of the South Indian State of Kerala

Background: The Geriatric Depression Scale (GDS-30) is a popular instrument that has been ratified and is being used around the world as a screening tool for over three decades. However, a validated version of the scale is not available for use among speakers of Malayalam. In this paper, we elaborate on the procedure involved in the translation and validation of the GDS-30 from the official English version into Malayalam, the hurdles encountered in the process, and how they were overcome. Methods: The steps recommended by the World Health Organization (WHO) were applied for the translation of the original questionnaire. This involved initial forward translation of the English questionnaire, discussion by an expert panel, back-translation, pre-testing, and pilot testing of the final version. The Malayalam translation thus obtained was administered to 100 elderly persons in the community. These individuals were then examined by a qualified doctor, who had received the necessary training from a consultant psychiatrist in the diagnosis of depressive disorders. This doctor evaluated the study subjects clinically using theInternational Classification of Diseases-tenth revision (ICD-10) criteria for the diagnosis of depression, which is considered as the gold standard. Sensitivity, specificity, Cronbach'salpha, and split-half reliability were calculated to determine validity. Results: The translated scale yielded a sensitivity of 87.20%, a specificity of 73.80%, an area under the Receiving Operator Curve (ROC) of 0.814, Cronbach's alpha of 0.920, and split-half reliability of 0.897, thereby proving to be a valid screening tool. Conclusion: The Malayalam translation of the GDS-30 is a valid instrument to screen for depression in an elderly Malayalam-speaking population.