Background: There is an increased interest in
developing better and more accurate methods to recognize and manage mental
health problems in primary care settings. Abbreviated screening instruments for
mental distress are useful tools for research and clinical practice. The
present study seeks to investigate whether only a few questionnaire items from
the Self-Reporting- Questionnaire-10 (SRQ-10) can be a robust method in the
screening for Mental Distress in Primary Health care. Methods: We compared the screening accuracy of a short, five-item
(SRQ-5) version of the SRQ-10 with that of the SRQ-20, General Health Questionnaire
12 (GHQ-12) using the DSM-IV axis as a gold standard and analyzed its
performance in different diagnostic entities. We also assessed the correlation,
sensitivity and specificity between the 4 instruments. All the instruments were
administered to 400 primary health care attendees. Results: The estimated prevalence of mental distress was 13.6% in
the study sample (Depression 11%, anxiety disorders 1.8%). The SRQ-5 was highly
correlated to SRQ-10 (0.923, p < 0.001), SRQ-20 (0.764, p < 0.001) and
only moderately correlated to GHQ-12 (0.417, p < 0.001). The SRQ-5 had high
properties for identifying mental distress. The AUC for overall mental distress
was 0.925 while that for depression and anxiety were 0.915 and 0.849
respectively. Conclusion: This validation
showed that in moving from SRQ with 10 or 20 items to one with
merely 5 items, we do not seem to lose the screening prowess of the instrument.
The SRQ-5 represents a simplified and less time-consuming screening instrument
with strong performance characteristics. We therefore recommend it for
inclusion into existing patient assessment protocols, thus enhancing case finding
at primary health care level.
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