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BMC Psychiatry
Published in: BMC Psychiatry 1/2008

Open Access 01-12-2008 | Research article

Concordance between Hopkins Symptom Checklist (HSCL-10) and Pakistan Anxiety and Depression Questionnaire (PADQ), in a rural self-motivated population in Pakistan

Authors: Hammad Raza Syed, Henrik Daae Zachrisson, Odd Steffen Dalgard, Ingvild Dalen, Nora Ahlberg

Published in: BMC Psychiatry | Issue 1/2008

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Abstract

Background

There have been no previous studies conducted in Pakistan comparing the concordance of any well established Western anxiety/depression screening instrument with an indigenous scale, in a community based setting.

Methods

Participants (n = 1040) in the present study were recruited from the six villages of our interest from the district Gujarat of Pakistan, using a convenient sampling technique. Interview versions of the Hopkins Symptom Checklist 10-item version (HSCL-10) and the Pakistani Anxiety and Depression Questionnaire (PADQ) were used to observe the pattern of anxiety and depression among the participants.

Results

The internal consistency of HSCL-10 and PADQ were 0.86 and 0.84 respectively. Exploratory factor analysis found evidence for both a one-dimensional (distress) and a two-dimensional (anxiety and depression) solution for the HSCL-10, but only a one-dimensional (distress) solution for the PADQ. The HSCL-10 and PADQ found to be moderately to highly correlated (r = 0.62, p < 0.0001, 0.73 after correction for attenuation).

Conclusion

HSCL-10 has shown good screening abilities in a rural setting in Pakistan, and moderate to good concordance with an indigenous instrument measuring psychological distress. The HSCL-10 can therefore be used as a screening instrument, both in clinical and epidemiological settings in Pakistan, and for Pakistani immigrants living in Western societies.
Literature
1.
Murray CLA: The global burden of diseases: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. 1996, Boston: Harvard School of Public Health, WHO and World Bank
2.
Karim S, Saeed K, Rana MH, Mubbashar MH, Jenkins R: Pakistan mental health country profile. Int Rev Psychiatry. 2004, 16: 83-92. 10.1080/09540260310001635131.CrossRefPubMed
3.
Mirza I, Jenkins R: Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. BMJ. 2004, 328: 794-10.1136/bmj.328.7443.794.CrossRefPubMedPubMedCentral
4.
Mumford DB: Somatic sensations and psychological distress among students in Britain and Pakistan. Soc Psychiatry Psychiatr Epidemiol. 1989, 24: 321-326. 10.1007/BF01788036.CrossRefPubMed
5.
Mumford DB, Bavington JT, Bhatnagar KS, Hussain Y, Mirza S, Naraghi MM: The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. Br J Psychiatry. 1991, 158: 379-386.CrossRefPubMed
6.
Mumford DB, Tareen IA, Bhatti MR, Bajwa MA, Ayub M, Pervaiz T: An investigation of 'functional' somatic symptoms among patients attending hospital medical clinics in Pakistan–II. Using somatic symptoms to identify patients with psychiatric disorders. J Psychosom Res. 1991, 35: 257-264. 10.1016/0022-3999(91)90079-4.CrossRefPubMed
7.
Mumford DB, Tareen IA, Bajwa MA, Bhatti MR, Pervaiz T, Ayub M: An investigation of 'functional' somatic symptoms among patients attending hospital medical clinics in Pakistan–I. Characteristics of 'non-organic' patients. J Psychosom Res. 1991, 35: 245-255. 10.1016/0022-3999(91)90078-3.CrossRefPubMed
8.
Mumford DB, Nazir M, Jilani FU, Baig IY: Stress and psychiatric disorder in the Hindu Kush: a community survey of mountain villages in Chitral, Pakistan. Br J Psychiatry. 1996, 168: 299-307.CrossRefPubMed
9.
Mumford DB, Saeed K, Ahmad I, Latif S, Mubbashar MH: Stress and psychiatric disorder in rural Punjab. A community survey. Br J Psychiatry. 1997, 170: 473-478.CrossRefPubMed
10.
Mumford DB, Minhas FA, Akhtar I, Akhter S, Mubbashar MH: Stress and psychiatric disorder in urban Rawalpindi. Community survey. Br J Psychiatry. 2000, 177: 557-562. 10.1192/bjp.177.6.557.CrossRefPubMed
11.
Husain N, Creed F, Tomenson B: Depression and social stress in Pakistan. Psychol Med. 2000, 30: 395-402. 10.1017/S0033291700001707.CrossRefPubMed
12.
Husain N, Gater R, Tomenson B, Creed F: Social factors associated with chronic depression among a population-based sample of women in rural Pakistan. Soc Psychiatry Psychiatr Epidemiol. 2004, 39: 618-624. 10.1007/s00127-004-0781-1.CrossRefPubMed
13.
Husain N, Chaudhry I, Afsar S, Creed F: Psychological distress among patients attending a general medical outpatient clinic in Pakistan. Gen Hosp Psychiatry. 2004, 26: 277-281. 10.1016/j.genhosppsych.2004.03.005.CrossRefPubMed
14.
Husain N, Gater R, Tomenson B, Creed F: Comparison of the Personal Health Questionnaire and the Self Reporting Questionnaire in rural Pakistan. J Pak Med Assoc. 2006, 56: 366-370.PubMed
15.
Husain N, Chaudhry IB, Afridi MA, Tomenson B, Creed F: Life stress and depression in a tribal area of Pakistan. Br J Psychiatry. 2007, 190: 36-41. 10.1192/bjp.bp.106.022913.CrossRefPubMed
16.
Rahman A, Iqbal Z, Waheed W, Hussain N: Translation and cultural adaptation of health questionnaires. J Pak Med Assoc. 2003, 53: 142-147.PubMed
17.
Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington R: Mothers' mental health and infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2004, 30: 21-27. 10.1111/j.1365-2214.2004.00382.x.CrossRefPubMed
18.
Fareed Aslam Minhas MHM: Validation of general health questionnaire in a primary care setting of Pakistan. JCPSP. 1995, 6: 133-136.
19.
Riaz H, Reza H: The evaluation of an Urdu version of the GHQ-28. Acta Psychiatr Scand. 1998, 97: 427-432. 10.1111/j.1600-0447.1998.tb10027.x.CrossRefPubMed
20.
Mumford DB, Tareen IA, Bajwa MA, Bhatti MR, Karim R: The translation and evaluation of an Urdu version of the Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1991, 83: 81-85. 10.1111/j.1600-0447.1991.tb07370.x.CrossRefPubMed
21.
Mumford DB, Ayub M, Karim R, Izhar N, Asif A, Bavington JT: Development and validation of a questionnaire for anxiety and depression in Pakistan. J Affect Disord. 2005, 88: 175-182. 10.1016/j.jad.2005.05.015.CrossRefPubMed
22.
Ali BS, Reza H, Khan MM, Jehan I: Development of an indigenous screening instrument in Pakistan: the Aga Khan University Anxiety and Depression Scale. J Pak Med Assoc. 1998, 48: 261-265.PubMed
23.
Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L: The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci. 1974, 19: 1-15. 10.1002/bs.3830190102.CrossRefPubMed
24.
Parloff MB, Kelman HC, Frank JD: Comfort, effectiveness, and self-awareness as criteria of improvement in psychotherapy. American Journal of Psychiatry. 1954, 111: 343-352.CrossRefPubMed
25.
Nettelbladt P, Hansson L, Stefansson CG, Borgquist L, Nordstrom G: Test characteristics of the Hopkins Symptom Check List-25 (HSCL-25) in Sweden, using the Present State Examination (PSE-9) as a caseness criterion. Soc Psychiatry Psychiatr Epidemiol. 1993, 28: 130-133. 10.1007/BF00801743.CrossRefPubMed
26.
Deane FP, Spicer J, Leathem J: Effects of videotaped preparatory information on expectations, anxiety, and psychotherapy outcome. J Consult Clin Psychol. 1992, 60: 980-984. 10.1037/0022-006X.60.6.980.CrossRefPubMed
27.
Tambs K, Moum T: How well can a few questionnaire items indicate anxiety and depression?. Acta Psychiatrica Scandinavica. 1993, 87: 364-367. 10.1111/j.1600-0447.1993.tb03388.x.CrossRefPubMed
28.
Hoffmann C, McFarland BH, Kinzie JD, Bresler L, Rakhlin D, Wolf S, et al: Psychological distress among recent Russian immigrants in the United States. Int J Soc Psychiatry. 2006, 52: 29-40. 10.1177/0020764006061252.CrossRefPubMed
29.
Sundquist K, Johansson LM, DeMarinis V, Johansson SE, Sundquist J: Posttraumatic stress disorder and psychiatric co-morbidity: symptoms in a random sample of female Bosnian refugees. Eur Psychiatry. 2005, 20: 158-164. 10.1016/j.eurpsy.2004.12.001.CrossRefPubMed
30.
Dalgard OS, Thapa SB, Hauff E, McCubbin M, Syed HR: Immigration, lack of control and psychological distress: findings from the Oslo Health Study. Scand J Psychol. 2006, 47: 551-558. 10.1111/j.1467-9450.2006.00546.x.CrossRefPubMed
31.
Kleijn WC, Hovens JE, Rodenburg JJ: Posttraumatic stress symptoms in refugees: assessments with the Harvard Trauma Questionnaire and the Hopkins symptom Checklist-25 in different languages. Psychol Rep. 2001, 88: 527-532. 10.2466/PR0.88.2.527-532.CrossRefPubMed
32.
Strand BH, Dalgard OS, Tambs K, Rognerud M: Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry. 2003, 57: 113-118. 10.1080/08039480310000932.CrossRefPubMed
33.
Tambs K: Moderate effects of hearing loss on mental health and subjective well-being: results from the Nord-Trondelag Hearing Loss Study. Psychosom Med. 2004, 66: 776-782. 10.1097/01.psy.0000133328.03596.fb.CrossRefPubMed
34.
Halepota AA, Wasif SA: Hopkins Symptoms Checklist 25(HSCL-25) Urdu translation: an instrument for detecting anxiety and depression in torture and trauma victims. J Pak Med Assoc. 2001, 51: 255-257.PubMed
35.
Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ: Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods. 1999, 4: 272-299. 10.1037/1082-989X.4.3.272.CrossRef
36.
Lord FMNMR: Statistical theories of mental test scores. 1968, Reading, MA: Addison Wesley edn
37.
Kaaya SF, Fawzi MC, Mbwambo JK, Lee B, Msamanga GI, Fawzi W: Validity of the Hopkins Symptom Checklist-25 amongst HIV-positive pregnant women in Tanzania. Acta Psychiatr Scand. 2002, 106: 9-19. 10.1034/j.1600-0447.2002.01205.x.CrossRefPubMed
38.
Frojdh K, Hakansson A, Karlsson I: The Hopkins Symptom Checklist-25 is a sensitive case-finder of clinically important depressive states in elderly people in primary care. Int J Geriatr Psychiatry. 2004, 19: 386-390. 10.1002/gps.1102.CrossRefPubMed
39.
Hinton WL, Du N, Chen YC, Tran CG, Newman TB, Lu FG: Screening for major depression in Vietnamese refugees: a validation and comparison of two instruments in a health screening population. J Gen Intern Med. 1994, 9: 202-206. 10.1007/BF02600124.CrossRefPubMed
40.
Leighton AH, Leighton DC, Danley RA: Validity in mental health surveys. Can Psychiatr Assoc J. 1966, 11: 167-178.PubMed
41.
Dohrenwend BP: The problem of validity in field studies in psychological disorders. Psychiatric epidemiology. Assessment, concepts and methods. Edited by: Mezzich JEJMSI. 1994, John Hopkins University Press, Baltimore London
42.
Harachi TW, Choi Y, Abbott RD, Catalano RF, Bliesner SL: Examining equivalence of concepts and measures in diverse samples. Prev Sci. 2006, 7: 359-368. 10.1007/s11121-006-0039-0.CrossRefPubMedPubMedCentral
43.
Ramirez M, Ford ME, Stewart AL, Teresi JA: Measurement issues in health disparities research. Health Serv Res. 2005, 40: 1640-1657. 10.1111/j.1475-6773.2005.00450.x.CrossRefPubMedPubMedCentral
44.
Sandanger I, Moum T, Ingebrigtsen G, Dalgard OS, Sorensen T, Bruusgaard D: Concordance between symptom screening and diagnostic procedure: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview I. Soc Psychiatry Psychiatr Epidemiol. 1998, 33: 345-354. 10.1007/s001270050064.CrossRefPubMed
45.
Ventevogel P, De VG, Scholte WF, Shinwari NR, Faiz H, Nassery R, et al: Properties of the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan. Soc Psychiatry Psychiatr Epidemiol. 2007, 42: 328-335. 10.1007/s00127-007-0161-8.CrossRefPubMed
46.
Okamoto K, Ohsuka K, Shiraishi T, Hukazawa E, Wakasugi S, Furuta K: Comparability of epidemiological information between self- and interviewer-administered questionnaires. J Clin Epidemiol. 2002, 55: 505-511. 10.1016/S0895-4356(01)00515-7.CrossRefPubMed
47.
Ross CE, Mirowsky J: Socially-desirable response and acquiescence in a cross-cultural survey of mental health. J Health Soc Behav. 1984, 25: 189-197. 10.2307/2136668.CrossRefPubMed
48.
Ichikawa M, Nakahara S, Wakai S: Cross-cultural use of the predetermined scale cutoff points in refugee mental health research. Soc Psychiatry Psychiatr Epidemiol. 2006, 41: 248-250. 10.1007/s00127-005-0016-2.CrossRefPubMed
49.
Furlanetto LM, Mendlowicz MV, Romildo BJ: The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. J Affect Disord. 2005, 86: 87-91. 10.1016/j.jad.2004.12.011.CrossRefPubMed
50.
Bolton P: Cross-cultural validity and reliability testing of a standard psychiatric assessment instrument without a gold standard. J Nerv Ment Dis. 2001, 189: 238-242. 10.1097/00005053-200104000-00005.CrossRefPubMed
Metadata
Title
Concordance between Hopkins Symptom Checklist (HSCL-10) and Pakistan Anxiety and Depression Questionnaire (PADQ), in a rural self-motivated population in Pakistan
Authors
Hammad Raza Syed
Henrik Daae Zachrisson
Odd Steffen Dalgard
Ingvild Dalen
Nora Ahlberg
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2008
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-8-59

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