Do they Actually Work Across Borders? Evaluation of two Measures of Psychological Distress as Screening Instruments in a Non Anglo-Saxon Country | European Psychiatry | Cambridge Core (original) (raw)

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Published online by Cambridge University Press: 16 April 2020

G. Carrà*

Affiliation:

Department of Mental Health Sciences, University College Medical School, Charles Bell House, 67–73, Riding House Street, London, W1W 7EY, UK Department of Neurosciences and Biomedical Technologies, University of Milano Bicocca Medical School, Via Cadore, 48, 20052Monza, Italy

P. Sciarini

Affiliation:

Department of Health Sciences, Section of Medical Statistics and Epidemiology, University of Pavia Medical School, Via Bassi, 21, 27100Pavia, Italy Department of Neurosciences and Biomedical Technologies, University of Milano Bicocca Medical School, Via Cadore, 48, 20052Monza, Italy

G. Segagni-Lusignani

Affiliation:

Department of Health Sciences, Section of Medical Statistics and Epidemiology, University of Pavia Medical School, Via Bassi, 21, 27100Pavia, Italy

M. Clerici

Affiliation:

Department of Neurosciences and Biomedical Technologies, University of Milano Bicocca Medical School, Via Cadore, 48, 20052Monza, Italy

C. Montomoli

Affiliation:

Department of Health Sciences, Section of Medical Statistics and Epidemiology, University of Pavia Medical School, Via Bassi, 21, 27100Pavia, Italy

R.C. Kessler

Affiliation:

Department of Health Care Policy, Harvard Medical School, 180, Longwood Avenue, Boston, MA 02115-5899, USA

Article contents

Abstract

Screening scales can be useful in searching for common mental disorders in primary care and in tracking relevant prevalence and correlates in community surveys. However, it is important to document their validity, before using them. We developed Italian versions of the widely-used K10 and K6 screening scales following the WHO forward-translation and back-translation protocol. To evaluate their effectiveness as screens for DSM-IV 12-month mood or anxiety disorders and “serious mental illness” (SMI), the scales were validated in a two-stage clinical reappraisal survey. In the first-phase, the scales were administered to 605 people. In the second-phase, a sub-sample of 147 first-phase respondents over-sampling screened positives was administered the 12-month version of the Structured Clinical Interview for DSM-IV Axis I Disorders as a clinical gold standard. Performance of the scales in screening for chosen disorders was assessed by calculating area under the receiver operating characteristic curve and stratum-specific likelihood ratios. Both the K10 and K6 performed well in detecting DSM-IV mood disorders, anxiety disorders, and serious mental illness (SMI), with areas under the curve (AUCs) (95% CIs) between 0.82 (0.75–0.89) and 0.91 (0.85–0.96). The Italian versions of the K6 and K10 scales have good psychometric properties, making them attractive inexpensive screens for mood disorders, anxiety disorders, and SMI.

Keywords

Type

Original article

Copyright

Copyright © Elsevier Masson SAS 2010

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References

Andrews, G.Slade, T.Interpreting scores on the Kessler psychological distress scale (K10). Aust N Z J Public Health 2001; 25: 494–497CrossRefGoogle Scholar

Baggaley, R.F.Ganaba, R.Filippi, V.Kere, M.Marshall, T.Sombié, I., et al.Detecting depression after pregnancy: the validity of the K10 and K6 in Burkina Faso. Trop Med Int Health 2007; 12: 1225–1229CrossRefGoogle ScholarPubMed

Cairney, J.Veldhuizen, S.Wade, T.J.Kurdyak, P.Streiner, D.L.Evaluation of 2 measures of psychological distress as screeners for depression in the general population. Can J Psychiatry 2007; 52: 111–120CrossRefGoogle ScholarPubMed

Cochran, W.Sampling techniques. 3rd ed. New York: Wiley: 1977Google Scholar

de Girolamo, G.Polidori, G.Morosini, P.Scarpino, V.Reda, V.Serra, G., et al.Prevalence of common mental disorders in Italy: results from the European study of the epidemiology of mental disorders (ESEMeD). Soc Psychiatry Psychiatr Epidemiol 2006; 41: 853–861CrossRefGoogle Scholar

Dunn, G.Pickles, A.Tansella, M.Vazquez-Barquero, J.L.Two-phase epidemiological surveys in psychiatric research. Br J Psychiatry 1999; 174: 95–100CrossRefGoogle ScholarPubMed

Endicott, J.Spitzer, R.L.Fleiss, J.L.Cohen, J.The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766–771CrossRefGoogle ScholarPubMed

Faravelli, C.Abrardi, L.Bartolozzi, D.Cecchi, C.Cosci, F.D’Adamo, D., et al.The Sesto Fiorentino study: point and one-year prevalence of psychiatric disorders in an Italian community sample using clinical interviewers. Psychother Psychosom 2004; 73: 226–234CrossRefGoogle Scholar

First, M.B.Spitzer, R.L.Gibbon, M.Williams, J.B.W.Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York: New York State Psychiatric Institute Biometrics Research Department: 2002Google Scholar

Furukawa, T.A.Goldberg, D.P.Rabe-Hesketh, S.Ustün, T.B.Stratum-specific likelihood ratios of two versions of the general health questionnaire. Psychol Med 2001; 31: 519–529CrossRefGoogle ScholarPubMed

Furukawa, T.A.Kawakami, N.Saitoh, M.Ono, Y.Nakane, Y.Nakamura, Y., et al.The performance of the Japanese version of the K6 and K10 in the world mental health survey Japan. Int J Methods Psychiatr Res 2008; 17: 152–158CrossRefGoogle ScholarPubMed

Furukawa, T.A.Kessler, R.C.Slade, T.Andrews, G.The performance of the K6 and K10 screening scales for psychological distress in the Australian national survey of mental health and well-being. Psychol Med 2003; 33: 357–362CrossRefGoogle ScholarPubMed

Gask, L.Klinkman, M.Fortes, S.Dowrick, C.Capturing complexity: the case for a new classification system for mental disorders in primary care. Eur Psychiatry 2008; 23: 469–476CrossRefGoogle ScholarPubMed

Goldberg, D.Blackwell, B.Psychiatric illness in a suburban general practice. A detailed study using a new method of case identification. Br Med J 1970; 2: 439–443CrossRefGoogle Scholar

Goldberg, D.Gater, R.Sartorius, N.Üstün, T.B.Piccinelli, M.Gureje, O., et al.The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 1997; 27: 191–197CrossRefGoogle ScholarPubMed

Henrysson, S.Correction of item-total correlations in item analysis. Psychometrika 1963; 28: 211–218CrossRefGoogle Scholar

Kessler, R.C.Andrews, G.Colpe, L.J.Hiripi, E.Mroczek, D.K.Normand, S.L.T., et al.Short screening scales to monitor population prevalences and trends in nonspecific psychological distress. Psychol Med 2002; 32: 959–976CrossRefGoogle Scholar

Kessler, R.C.Barker, P.R.Colpe, L.J.Epstein, J.F.Gfroerer, J.C.Hiripi, E., et al.Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003; 60: 184–189CrossRefGoogle ScholarPubMed

Kessler, R.C.Ustun, T.B.The World mental health (WMH) survey initiative version of the World Health Organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 2004; 13: 93–121CrossRefGoogle Scholar

Moons, K.G.M.van Es, G.A.Deckers, J.W.Habbema, J.D.F.Grobbee, D.E.Limitations of sensitivity, specificity, likelihood ratio, and Bayes’ theorem in assessing diagnostic probabilities: a clinical example. Epidemiology 1996; 8: 12–17CrossRefGoogle Scholar

Newman, S.C.Shrout, P.E.Bland, R.C.The efficiency of two-phase designs in prevalence surveys of mental disorders. Psychol Med 1990; 20: 183–193CrossRefGoogle ScholarPubMed

Patel, V.Araya, R.Chowdhary, N.King, M.Kirkwood, B.Nayak, S., et al.Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med 2008; 38: 221–228CrossRefGoogle ScholarPubMed

Peck, M.C.Scheffler, R.M.An analysis of the definitions of mental illness used in state parity laws. Psychiatr Serv 2002; 53: 1089–1095CrossRefGoogle ScholarPubMed

Peirce, J.C.Cornell, R.G.Integrating stratum-specific likelihood ratios with the analysis of ROC curves. Med Decis Making 1993; 13: 141–151CrossRefGoogle ScholarPubMed

Ransohoff, D.F.Feinstein, A.R.Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med 1978; 299: 926–930CrossRefGoogle ScholarPubMed

Rey, J.M.Morris-Yates, A.Stanislaw, H.Measuring the accuracy of diagnostic tests using receiver operating characteristic curves derived from the same cases. Int J Methods Psychiatr Res 1992; 2: 1–11Google Scholar

Rossi, P.H.Wright, J.D.Anderson, A.B.Handbook of Survey Research. New York: Academic Press: 1983Google Scholar

Ruggeri, M.Leese, M.Thornicroft, G.Bisoffi, G.Tansella, M.Definition and prevalence of severe and persistent mental illness. Br J Psychiatry 2000; 177: 149–155CrossRefGoogle ScholarPubMed

Schmitz, N.Kruse, J.Tress, W.Application of stratum-specific likelihood ratios in mental health screening. Soc Psychiatry Psychiatr Epidemiol 2000; 35: 375–379CrossRefGoogle ScholarPubMed

Sox, H.C. Jr.Probability theory in the use of diagnostic tests. An introduction to critical study of the literature. Ann Intern Med 1986; 104: 60–66CrossRefGoogle ScholarPubMed

Viola, R.Lovas, K.Szabo, Z.Czenner, Z.Meads, D.M.Soos, G., et al.Evaluation of the psychometric properties of the Hungarian quality of life in depression scale. Eur Psychiatry 2008; 23: 49–52CrossRefGoogle ScholarPubMed

Ware, J.Sherbourne, C.The SF-36 short-form health status survey: 1. Conceptual framework and item selection. Med Care 1992; 3: 473–481CrossRefGoogle Scholar

Whiting, P.Rutjes, A.W.Reitsma, J.B.Glas, A.S.Bossuyt, P.M.Kleijnen, J.Sources of variation and bias in studies of diagnostic accuracy: a systematic review. Ann Intern Med 2004; 140: 189–202CrossRefGoogle ScholarPubMed

Wittchen, H.U.Continued needs for epidemiological studies of mental disorders in the community. Psychother Psychosom 2004; 73: 197–206CrossRefGoogle Scholar

Wittchen, H.U.Jacobi, F.Size and burden of mental disorders in Europe – a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol 2005; 15: 357–376CrossRefGoogle ScholarPubMed