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Do they Actually Work Across Borders? Evaluation of two Measures of Psychological Distress as Screening Instruments in a Non Anglo-Saxon Country

Published online by Cambridge University Press:  16 April 2020

G. Carrà ,
P. Sciarini ,
G. Segagni-Lusignani ,
M. Clerici ,
C. Montomoli  and
R.C. Kessler
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
*
⁎Tel.: +44 20 7679 9428; fax: +44 20 7679 9426. E-mail addresses: [email protected], [email protected] (G. Carra` ).
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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

AnxietyDepressionMental disordersScreening
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 2 , March 2011 , pp. 122 - 127
Copyright
Copyright © Elsevier Masson SAS 2010

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