Comparative Validity of Screening Instruments for Mental Distress in Zambia

Chipimo, Peter J.; Fýlkesnes, Knut

doi:10.2174/17450179010060100004

Cited by 4 publications

(11 citation statements)

References 23 publications

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“…Studies conducted in Rwanda and Brazil have also reported gender differences in SRQ scores, with higher cutoff scores performing better for female participants than for their male counterparts (Scholte et al 2011a; Mari and Williams 1986; Gonçalves et al 2008). However, a few studies have found no difference in optimal cutoff scores in males and females (Giang et al 2006; Chipimo and Fylkesnes 2010). It has been recommended that optimal cutoff scores be explored in different settings before the screening tools are used in research or clinical practice (Scholte et al 2011b; Harpham et al 2003).…”

Section: Discussionmentioning

confidence: 99%

Validation of the Self Reporting Questionnaire 20-Item (SRQ-20) for Use in a Low- and Middle-Income Country Emergency Centre Setting

Westhuizen

Wyatt

Williams

et al. 2015

Int J Ment Health Addiction

112

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Common mental disorders are highly prevalent in emergency centre (EC) patients, yet few brief screening tools have been validated for low- and middle-income country (LMIC) ECs. This study explored the psychometric properties of the SRQ-20 screening tool in South African ECs using the Mini Neuropsychiatric Interview (MINI) as the gold standard comparison tool. Patients (n=200) from two ECs in Cape Town, South Africa were interviewed using the SRQ-20 and the MINI. Internal consistency, screening properties and factorial validity were examined. The SRQ-20 was effective in identifying participants with major depression, anxiety disorders or suicidality and displayed good internal consistency. The optimal cutoff scores were 4/5 and 6/7 for men and women respectively. The factor structure differed by gender. The SRQ-20 is a useful tool for EC settings in South Africa and holds promise for task-shifted approaches to decreasing the LMIC burden of mental disorders.

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Section: Discussionmentioning

confidence: 99%

Validation of the Self Reporting Questionnaire 20-Item (SRQ-20) for Use in a Low- and Middle-Income Country Emergency Centre Setting

Westhuizen

Wyatt

Williams

et al. 2015

Int J Ment Health Addiction

112

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“…Originally a 60 item questionnaire, it has been variously abbreviated to 30, 28, 20 and 12 item versions. There are many validity studies of the 28 item, 30 item and 60 item versions including in Kenya and other developing countries [14,34,36-44] but relatively few of the 12 item version [14,36,42-46], although it has been validated in several African studies [47,48]. The GHQ-12 takes two minutes to complete by a literate person, and is very useful in situations where because of widespread illiteracy, the questions have to be read out to the respondent [47].…”

Section: Methodsmentioning

confidence: 99%

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

Jenkins¹,

Othieno

Okeyo

et al. 2013

Int J Ment Health Syst

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Trial designA pragmatic cluster randomised controlled trial.MethodsParticipants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment.ResultsNumbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified.ConclusionThe training programme did not result in significantly improved recorded diagnostic rates of mental disorders in the routine clinic consultation register, but did have significant effects on patient outcomes in routine clinical practice.Trial registrationInternational Standard Randomised Controlled Trial Number Register ISRCTN53515024.

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“…This research was part of a larger study aimed at validating the use of SRQ-10 as a screening instrument and to assess mental health changes in people living with HIV/AIDS (PLWHA)[3,4]. We assessed primary health seekers at four primary health care centers in Lusaka, Zambia between December 2008 and May 2009.…”

Section: Methodsmentioning

confidence: 99%

“…There is much debate concerning the most effective way to measure mental distress. Several instruments, most of which are based on self-report systems, have been suggested for detecting mental distress, including the Self-Reporting questionnaire (SRQ), Symptom Check List (SCL) and General Health Questionnaire (GHQ), and the validity of these methods have been published[4-6]. Cultural construction of mental distress is important[7,8].…”

Section: Introductionmentioning

confidence: 99%

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Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia

Chipimo

Tuba

Fýlkesnes

2011

BMC Health Serv Res

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BackgroundMental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms.MethodsQualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies.ResultsMental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection.ConclusionsPatient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals.

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Comparative Validity of Screening Instruments for Mental Distress in Zambia

Cited by 4 publications

References 23 publications

Validation of the Self Reporting Questionnaire 20-Item (SRQ-20) for Use in a Low- and Middle-Income Country Emergency Centre Setting

Validation of the Self Reporting Questionnaire 20-Item (SRQ-20) for Use in a Low- and Middle-Income Country Emergency Centre Setting

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia

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