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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Identifying levels of general distress in first line mental health services: can GP- and eHealth clients’ scores be meaningfully compared?

Authors: Jan van Bebber, Johanna T. W. Wigman, Lex Wunderink, Jorge N. Tendeiro, Marieke Wichers, Janneke Broeksteeg, Bart Schrieken, Sjoerd Sytema, Berend Terluin, Rob R. Meijer

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

The Four-Dimensional Symptom Questionnaire (4DSQ) (Huisarts Wetenschap 39: 538–47, 1996) is a self-report questionnaire developed in the Netherlands to distinguish non-specific general distress from depression, anxiety, and somatization. This questionnaire is often used in different populations and settings and there is a paper-and-pencil and computerized version.

Methods

We used item response theory to investigate whether the 4DSQ measures the same construct (structural equivalence) in the same way (scalar equivalence) in two samples comprised of primary mental health care attendees: (i) clients who visited their General Practitioner responded to the 4DSQ paper-and-pencil version, and (ii) eHealth clients responded to the 4DSQ computerized version. Specifically, we investigated whether the distress items functioned differently in eHealth clients compared to General Practitioners’ clients and whether these differences lead to substantial differences at scale level.

Results

Results showed that in general structural equivalence holds for the distress scale. This means that the distress scale measures the same construct in both General Practitioners’ clients and eHealth clients. Furthermore, although eHealth clients have higher observed distress scores than General Practitioners’ clients, application of a multiple group generalized partial credit response model suggests that scalar equivalence holds.

Conclusions

The same cutoff scores can be used for classifying respondents as having low, moderate and high levels of distress in both settings.
Appendix
Available only for authorised users
Footnotes
1
Interapy® originated from the University of Amsterdam. It is a certified provider for primary- and specialized mental health care, with a special interest in research. For more than 10 years, the organization has been offering evidence-based eHealth interventions for various mental health disorders. Only secured/protected websites are used for the contact between coach/therapist and health care recipient.
 
2
A detailed description of the procedure we used to test items for DIF can be found in the Additional file 1 in the section Technical details DIF tests.
 
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Metadata
Title
Identifying levels of general distress in first line mental health services: can GP- and eHealth clients’ scores be meaningfully compared?
Authors
Jan van Bebber
Johanna T. W. Wigman
Lex Wunderink
Jorge N. Tendeiro
Marieke Wichers
Janneke Broeksteeg
Bart Schrieken
Sjoerd Sytema
Berend Terluin
Rob R. Meijer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1552-3

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