Background: Assessment of the growing prevalence of depression in developing countries is hampered by a lack of valid diagnostic instruments for the local settings.
Aim and method: This study attempted to examine the validity of the 25-item Hopkins Symptom Checklist (HSCL-25) in a special primary care population in Dar es Salaam, Tanzania.
Results: 787 antenatal participants were recruited, and their responses revealed good internal consistency, interrater reliability, and test-retest reliability, and the scale was validated using content, construct, and discriminant validation methods. Factor analysis of the depression subscale, however, confirmed the need for a locally developed scale.
Conclusions: Integrating universalist and relativist approaches, through the validation and modification of scales, may help in the detection of depression in cross-cultural settings.
Get full access to this article
View all access options for this article.
References
1.
Aaronson, N.K., Acquadro, C., Alonso, J., et al. (1992) International Quality of Life Assessment (IQOLA) project. Quality of Life Research, 1, 349—351.
2.
Abas, M.A. & Broadhead, J.C. (1997) Depression and anxiety among women in an urban setting in Zimbabwe. Psychological Medicine , 27, 59—71.
3.
Bolton, P., Wilk, C.M. & Ndogoni, L. (2004) Assessment of depression prevalence in rural Uganda using symptom and function criteria. Social Psychiatry & Psychiatric Epidemiology, 39, 442—447.
4.
Derogatis, L.R., Lipman, R.S., Rickels, K., et al. (1974) The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behavioral Science, 19, 1—15.
5.
Guelfi, J.D., Barthelet, G., Lancrenon, S., et al. (1984) Structure factorielle de la H.S.C.L. sur un échantillon de patients anxio-dépressifs français. Annals of Medicine andPsychology, 142, 889—996.
6.
Harding, T.W., De Arango, M.V., Baltazar, J., et al. (1980) Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychological Medicine, 10, 231—241.
7.
Hesbacher, P.T., Rickels, K., Morris, R.J., et al. (1980) Psychiatric illness in family practice. Journal ofClinical Psychiatry, 41, 6—10.
8.
Mollica, R.F., Wyshak, G., De Marneffe, D., et al. (1987) Indochinese version of the Hopkins Symptom Checklist-25: a screening instrument for psychiatric care of refugees. American Journal of Psychiatry,144, 497—500.
9.
Murray, C.J.L. & Lopez, A.D. (1997) Alternative projections of mortality and disability by cause 1990—2020: global burden of disease study. Lancet, 349, 1498—1504.
10.
Perez, S. & Junod, A. (1998) La depression en Afrique sub-saharienne. Médecine tropicale, 58, 168—176.
11.
Pritchard, D.B. & Harris, B. (1996) Aspects of perinatal psychiatric illness. British Journal of Psychiatry, 169, 555—562.
12.
Smith-Fawzi, M.C., Sternfels, P., Mbwambo, J., et al. (1999) Validity of assessing quality of life among HIV-positive women in Dar es Salaam, Tanzania (unpublished).
13.
Thakker, J. & Ward, T. (1998) Culture and classification. The cross-cultural application of the DSM-IV. Clinical Psychology Review, 18, 501—529.
14.
Van De Vijver, F.J.R. & Poortinga, Y.H. (1991) Testing across cultures . In Advances in Educational and Psychological Testing (eds R.K. Hambleton & J.N. Zaal, pp. 277—308). Boston: Kluwer Academic.
15.
Wagner, A.K., Wyss, K., Gandek, B., et al. (1999) A Kiswahili version of the SF-36 Health Survey for use in Tanzania: translation and tests of scaling assumptions. Quality of Life Research, 8, 101—110.
16.
Ware, J.E. & Sherbourne, C.D. (1992) The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473—483.
17.
Ware, J.E., Gandek, B.L., Keller, S.D., et al. (1996) Evaluating instruments used cross-nationally: methods from the IQOLA Project. In Quality of Life and Pharmacoeconomics in Clinical Trials (ed. B. Spiker). Philadelphia: Lippincott-Raven.
18.
Whyte, S.R. (1991) Attitudes towards mental health problems in Tanzania . Acta Psychiatrica Scandinavica Suppl., 364,59—76.
19.
Winokur, A., Winokur, D.F., Rickels, K., et al. (1984) Symptoms of emotional stress in family planning service: Stability over a four-week period. British Journal of Psychiatry, 144, 395—399.
20.
Wyss, K., Wagner, A.K., Whiting, D., et al. (1999) Validation of the Kiswahili version of the SF-36 Health Survey in a representative sample of an urban population in Tanzania . Quality of Life Research, 8, 111—120.
