Detecting Depression and Anxiety Among Adolescents in South Africa: Validity of the isiXhosa Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7.

Journal: The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Volume: 72

Issue: 1S

Year of Publication: 2022

Affiliated Institutions:  Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Electronic address: marlow@sun.ac.za. Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands. Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University College, Stockholm, Sweden. Department of Psychiatry, George Washington University, Washington, District of Columbia. Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York, New York. Division of Global Surgery, University of Cape Town, Cape Town, South Africa. Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; School of Nursing and Midwifery, Queens University, Belfast, United Kingdom.

Abstract summary 

Screening tools such as the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) could potentially be used in resource-limited settings to identify adolescents who need mental health support. We examined the criterion validity of the isiXhosa versions of the PHQ-9 and GAD-7 in detecting depression and anxiety among adolescents (10-19 years) in South Africa.Adolescents were recruited from the general population and from nongovernmental organizations working with adolescents in need of mental health support. The PHQ-9 and GAD-7 were culturally adapted and translated into isiXhosa and administered to 302 adolescents (56.9% female). The Kiddie Schedule for Affective Disorders and Schizophrenia was administered by trained clinicians as the gold standard diagnostic measure for depression and anxiety.For the PHQ-9, the area under the curve was 0.88 for the full sample of adolescents (10-19 years old). A score of ≥10 had 91% sensitivity and 76% specificity for detecting adolescents with depression. For the GAD-7, the area under the curve was 0.78, and cutoff scores with an optimal sensitivity-specificity balance were low (≥6). A score of ≥6 had 67% sensitivity and 75% specificity for detecting adolescents with anxiety.The culturally adapted isiXhosa version of the PHQ-9 can be used as a valid measure for depression in adolescents. Further research on the GAD-7 for use with adolescents is recommended.

Authors & Co-authors:  Marlow Marguerite M Skeen Sarah S Grieve Caitlin M CM Carvajal-Velez Liliana L Åhs Jill W JW Kohrt Brandon A BA Requejo Jennifer J Stewart Jackie J Henry Junita J Goldstone Daniel D Kara Tashmira T Tomlinson Mark M

Study Outcome 

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Citations : 
Authors :  12
Identifiers
Doi : 10.1016/j.jadohealth.2022.09.013
SSN : 1879-1972
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Adolescents;Anxiety;Depression;Diagnostic assessment;GAD-7;Low- and middle-income countries;Mental health;PHQ-9;Screening;Validity
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States