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30.06.2017 | Original Paper

Reliability, Validity, and Factor Structure of the Hopkins Symptom Checklist-25: Population-Based Study of Persons Living with HIV in Rural Uganda

verfasst von: Scholastic Ashaba, Bernard Kakuhikire, Dagmar Vořechovská, Jessica M. Perkins, Christine E. Cooper-Vince, Samuel Maling, David R. Bangsberg, Alexander C. Tsai

Erschienen in: AIDS and Behavior | Ausgabe 5/2018

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Abstract

Depression and anxiety are highly comorbid among people living with HIV (PLHIV), but few instruments for screening or measurement have been validated for use in sub-Saharan Africa. The objective of this study was to determine the reliability, validity, and factor structure of the 25-item Hopkins Symptom Checklist (HSCL) in a population-based sample of PLHIV in rural Uganda. This study was nested within an ongoing population-based cohort of all residents living in Nyakabare Parish, Mbarara District, Uganda. All participants who identified as HIV-positive by self-report were included in this analysis. We performed parallel analysis on the scale items and estimated the internal consistency of the identified sub-scales using ordinal alpha. To assess construct validity we correlated the sub-scales with related constructs, including subjective well being (happiness), food insecurity, and health status. Of 1814 eligible adults in the population, 158 (8.7%) self-reported being HIV positive. The mean age was 41 years, and 68% were women. Mean HSCL-25 scores were higher among women compared with men (1.71 vs. 1.44; t = 3.6, P < 0.001). Parallel analysis revealed a three-factor structure that explained 83% of the variance: depression (7 items), anxiety (5 items), and somatic symptoms (7 items). The ordinal alpha statistics for the sub-scales ranged from 0.83 to 0.91. Depending on the sub-scale, between 27 and 41% of the sample met criteria for caseness. Strong evidence of construct validity was shown in the estimated correlations between sub-scale scores and happiness, food insecurity, and self-reported overall health. The HSCL-25 is a reliable and valid measure of mental health among PLHIV in rural Uganda. In cultural contexts where somatic complaints are commonly elicited when screening for symptoms of depression, it may be undesirable to exclude somatic items from depression symptom checklists administered to PLHIV.

GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603–58.CrossRef

Weiser SD, Wolfe WR, Bangsberg DR. The HIV epidemic among individuals with mental illness in the United States. Curr HIV/AIDS Rep. 2004;1(4):186–92.CrossRefPubMed

Bing EG, Burnam MA, Longshore D, et al. Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.CrossRefPubMed

Tsai AC. Reliability and validity of depression assessment among persons with HIV in sub-Saharan Africa: systematic review and meta-analysis. J Acquir Immune Defic Syndr. 2014;66(5):503–11.CrossRefPubMedPubMedCentral

Tsai AC, Weiser SD, Petersen ML, Ragland K, Kushel MB, Bangsberg DR. A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV. Arch Gen Psychiatry. 2010;67(12):1282–90.CrossRefPubMedPubMedCentral

Sikkema KJ, Watt MH, Drabkin AS, Meade CS, Hansen NB, Pence BW. Mental health treatment to reduce HIV transmission risk behavior: a positive prevention model. AIDS Behav. 2010;14(2):252–62.CrossRefPubMedPubMedCentral

Pence BW, Gaynes BN, Adams JL, et al. The effect of antidepressant treatment on HIV and depression outcomes: results from a randomized trial. AIDS. 2015;29(15):1975–86.CrossRefPubMedPubMedCentral

Seth P, Kidder D, Pals S, et al. Psychosocial functioning and depressive symptoms among HIV-positive persons receiving care and treatment in Kenya, Namibia, and Tanzania. Prev Sci. 2014;15(3):318–28.CrossRefPubMedPubMedCentral

Nel A, Kagee A. Common mental health problems and antiretroviral therapy adherence. AIDS Care. 2011;23(11):1360–5.CrossRefPubMed

10.

Wagner GJ, Ghosh-Dastidar B, Robinson E, et al. Effects of depression alleviation on ART adherence and HIV clinic attendance in Uganda, and the mediating roles of self-efficacy and motivation. AIDS Behav. 2017;216(6):1655–64.CrossRef

11.

Kagee A, Tsai AC, Lund C, Tomlinson M. Screening for common mental disorders: reasons for caution and a way forward. Int Health. 2013;5(1):11–4.CrossRefPubMed

12.

Cherian VI, Peltzer K, Cherian L. The factor-structure of the Self Reporting Questionnaire (SRQ-20) in South Africa. East Afr Med J. 1998;75(11):654–6.PubMed

13.

Okello ES, Ekblad S. Lay concepts of depression among the Baganda of Uganda: a pilot study. Transcult Psychiatry. 2006;43(2):287–313.CrossRefPubMed

14.

Tomlinson M, Swartz L, Kruger LM, Gureje O. Manifestations of affective disturbance in sub-Saharan Africa: key themes. J Affect Disord. 2007;102(1–3):191–8.CrossRefPubMed

15.

Akena D, Joska J, Obuku EA, Stein DJ. Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda. AIDS Care. 2013;25(10):1245–52.CrossRefPubMed

16.

Kalichman SC, Sikkema KJ, Somlai A. Assessing persons with human immunodeficiency virus (HIV) infection using the Beck Depression Inventory: disease processes and other potential confounds. J Pers Assess. 1995;64(1):86–100.CrossRefPubMed

17.

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(1):9–19.CrossRefPubMed

18.

Tsai AC, Bangsberg DR, Emenyonu N, Senkungu JK, Martin JN, Weiser SD. The social context of food insecurity among persons living with HIV/AIDS in rural Uganda. Soc Sci Med. 2011;73(12):1717–24.CrossRefPubMedPubMedCentral

19.

Tsai AC, Kakuhikire B, Mushavi R, et al. Population-based study of intra-household gender differences in water insecurity: reliability and validity of a survey instrument for use in rural Uganda. J Water Health. 2016;14(2):280–92.CrossRefPubMedPubMedCentral

20.

National Statistical Office and ICF Macro. Malawi Demographic and Health Survey 2010. Calverton: ICF Macro; 2011.

21.

Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L. The Hopkins Symptom Checklist (HSCL). A measure of primary symptom dimensions. Mod Probl Pharmacopsychiatr. 1974;7:79–110.CrossRef

22.

Bolton P, Ndogoni L. Cross-cultural assessment of trauma-related mental illness (Phase II): a report of research conducted by World Vision Uganda and The Johns Hopkins University. 2001. http://www.certi.org/publications/policy/ugandafinalreport.htm. Accessed April 23, 2011.

23.

Pavot W, Diener E. Review of the satisfaction with life scale. Psychol Assess. 1993;5(2):164–72.CrossRef

24.

Diener E, Suh EM, Lucas RE, Smith HL. Subjective well-being: three decades of progress. Psychol Bull. 1999;125(2):276–302.CrossRef

25.

Tsai AC, Tomlinson M, Comulada WS, Rotheram-Borus MJ. Food insufficiency, depression, and the modifying role of social support: evidence from a population-based, prospective cohort of pregnant women in peri-urban South Africa. Soc Sci Med. 2016;151:69–77.CrossRefPubMedPubMedCentral

26.

Cole SM, Tembo G. The effect of food insecurity on mental health: panel evidence from rural Zambia. Soc Sci Med. 2011;73(7):1071–9.CrossRefPubMed

27.

Tsai AC, Bangsberg DR, Frongillo EA, et al. Food insecurity, depression and the modifying role of social support among people living with HIV/AIDS in rural Uganda. Soc Sci Med. 2012;74(12):2012–9.CrossRefPubMedPubMedCentral

28.

Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37.CrossRefPubMed

29.

Jylha M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009;69(3):307–16.CrossRefPubMed

30.

Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30(2):179–85.CrossRefPubMed

31.

Glorfeld LW. An improvement on Horn’s parallel analysis methodology for selecting the correct number of factors to retain. Educ Psychol Meas. 1995;55(3):377–93.CrossRef

32.

Dinno A. Implementing Horn’s parallel analysis for principal component analysis and factor analysis. Stata J. 2009;9(2):192–298.

33.

Gadermann AM, Guhn M, Zumbo BD. Estimating ordinal reliability for Likert-type and ordinal item response data: a conceptual, empirical, and practical guide. Pract Assess Res Eval. 2012;17(3):1–13.

34.

Winokur A, Winokur DF, Rickels K, Cox DS. Symptoms of emotional distress in a family planning service: stability over a four-week period. Br J Psychiatry. 1984;144:395–9.CrossRefPubMed

35.

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(4):202–6.CrossRefPubMed

36.

Mollica RF, Wyshak G, de Marneffe D, Khuon F, Lavelle J. Indochinese versions of the Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psychiatry. 1987;144(4):497–500.CrossRefPubMed

37.

Fisher RA. On the “probable error” of a coefficient of correlation deduced from a small sample. Metron. 1921;1(4):3–32.

38.

Seed PT. sg159: confidence intervals for correlations. Stata Tech Bull. 2001;59(1):27–8.

39.

Lee B, Kaaya SF, Mbwambo JK, Smith-Fawzi MC, Leshabari MT. Detecting depressive disorder with the Hopkins Symptom Checklist-25 in Tanzania. Int J Soc Psychiatry. 2008;54(1):7–20.CrossRefPubMed

40.

Kaharuza FM, Bunnell R, Moss S, et al. Depression and CD4 cell count among persons with HIV infection in Uganda. AIDS Behav. 2006;10(4 Suppl):S105–11.CrossRefPubMed

41.

Olley BO, Seedat S, Nei DG, Stein DJ. Predictors of major depression in recently diagnosed patients with HIV/AIDS in South Africa. AIDS Patient Care STDs. 2004;18(8):481–7.CrossRefPubMed

42.

Amberbir A, Woldemichael K, Getachew S, Girma B, Deribe K. Predictors of adherence to antiretroviral therapy among HIV-infected persons: a prospective study in Southwest Ethiopia. BMC Public Health. 2008;8:265.CrossRefPubMedPubMedCentral

43.

Marwick KF, Kaaya SF. Prevalence of depression and anxiety disorders in HIV-positive outpatients in rural Tanzania. AIDS Care. 2010;22(4):415–9.CrossRefPubMed

44.

Ramadhani HO, Thielman NM, Landman KZ, et al. Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Clin Infect Dis. 2007;45(11):1492–8.CrossRefPubMed

45.

Okello ES, Ngo VK, Ryan G, et al. Qualitative study of the influence of antidepressants on the psychological health of patients on antiretroviral therapy in Uganda. Afr J AIDS Res. 2012;11(1):37–44.CrossRefPubMed

46.

Okello ES, Neema S. Explanatory models and help-seeking behavior: pathways to psychiatric care among patients admitted for depression in Mulago hospital, Kampala, Uganda. Qual Health Res. 2007;17(1):14–25.CrossRefPubMed

47.

Okello ES. Cultural explanatory models of depression in Uganda. Stockholm: Institutionen för Klinisk Neurovetenskap, Karolinska Institutet;2006. 9171408231.

48.

Kalichman SC, Rompa D, Cage M. Distinguishing between overlapping somatic symptoms of depression and HIV disease in people living with HIV-AIDS. J Nerv Ment Dis. 2000;188(10):662–70.CrossRefPubMed

49.

Okello ES, Musisi S. Depression as a clan illness (eByekika): an indigenous model of psychotic depression among the Baganda of Uganda. World Cult Psych Res Rev. 2006;1(2):60–73.

50.

Ndetei DM, Muhangi J. The prevalence and clinical presentation of psychiatric illness in a rural setting in Kenya. Br J Psychiatry. 1979;135:269–72.CrossRefPubMed

51.

Kaaya SF, Lee B, Mbwambo JK, Smith-Fawzi MC, Leshabari MT. Detecting depressive disorder with a 19-item local instrument in Tanzania. Int J Soc Psychiatry. 2008;54(1):21–33.CrossRefPubMed

52.

Bunnell R, Opio A, Musinguzi J, et al. HIV transmission risk behavior among HIV-infected adults in Uganda: results of a nationally representative survey. AIDS. 2008;22(5):617–24.CrossRefPubMed

53.

Chan BT, Weiser SD, Boum Y, et al. Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion. AIDS. 2015;29(1):83–90.CrossRefPubMedPubMedCentral

54.

Chan BT, Tsai AC, Siedner MJ. HIV treatment scale-up and HIV-related stigma in sub-Saharan Africa: a longitudinal cross-country analysis. Am J Public Health. 2015;105(8):1581–7.CrossRefPubMedPubMedCentral

55.

Chan BT, Tsai AC. HIV stigma trends in the general population during antiretroviral treatment expansion: analysis of 31 countries in sub-Saharan Africa, 2003-2013. J Acquir Immune Defic Syndr. 2016;72(5):558–64.PubMedPubMedCentral

56.

Uganda Ministry of Health. Uganda AIDS Indicator Survey 2011. Kampala: Uganda Ministry of Health and Calverton: ICF International; 2012.

Titel: Reliability, Validity, and Factor Structure of the Hopkins Symptom Checklist-25: Population-Based Study of Persons Living with HIV in Rural Uganda
verfasst von: Scholastic Ashaba
Bernard Kakuhikire
Dagmar Vořechovská
Jessica M. Perkins
Christine E. Cooper-Vince
Samuel Maling
David R. Bangsberg
Alexander C. Tsai
Publikationsdatum: 30.06.2017
Verlag: Springer US
Erschienen in: AIDS and Behavior / Ausgabe 5/2018
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-017-1843-1

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