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International Journal of Social Psychiatry, Vol. 54, No. 1, 21-33 (2008)
DOI: 10.1177/0020764006075024

Detecting Depressive Disorder With a 19-Item Local Instrument in Tanzania

Sylvia F. Kaaya

Muhimbili University College of Health Sciences

Bandy Lee

Yale University School of Medicine, blee{at}aya.yale.edu

Jessie K. Mbwambo

Muhimbili University College of Health Sciences

Mary C. Smith-Fawzi

Harvard University Medical School

Melkizedek T. Leshabari

Muhimbili University Institute of Public Health

Background: Based on experience with the Hopkins Symptom Checklist-25 (HSCL-25) in a Tanzanian population, this study attempted to develop a locally specific screen that employs indigenous expressions.

Aim and method: Thirty ethnographically derived local idioms were added and the final 47-item questionnaire administered to 787 randomly selected antenatal clinic attendees.

Results: Logistic regression identified 19 items for the Dar-es-Salaam Symptom Questionnaire (DSQ), which demonstrated good internal consistency (Cronbach's {alpha} = 0.84), interrater reliability (intraclass r = 0.89), and test-retest reliability (intraclass r = 0.82). Positive endorsement overall increased only slightly, but the report of mild symptoms was more frequent with the DSQ (15.0%) than the HSCL-25 (10.8%). Content and discriminant validation of the local scale conformed to expectation, but depressed affect failed to emerge as an important feature.

Conclusion: Locally derived expressions may aid in the reporting of illness and illness severity. Further studies are recommended to uncover universal aspects and culturally specific manifestations of illness expression.

Declaration of interest: None to report.


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